scholarly journals First recourse for care-seeking and associated factors among rural populations in the eastern Democratic Republic of the Congo

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wyvine Ansima Bapolisi ◽  
Hermès Karemere ◽  
Freddy Ndogozi ◽  
Aimé Cikomola ◽  
Ghislain Kasongo ◽  
...  
Keyword(s):  
Health Service ◽  
Service Use ◽  
Democratic Republic ◽  
Health Centers ◽  
Morbidity Rate ◽  
Sample Population ◽  
Fisher Exact Test ◽  
Level Of Education ◽  
Republic Of The Congo ◽  
The Cost

Abstract Background Access to quality healthcare is a global fundamental human right. However, in the Democratic Republic of the Congo, several parameters affect the choices of health service users in fragile, rural contexts (zones). The overarching aim of this study was to identify the first recourse of healthcare-seeking and the determinants of utilization of health centers (primary health care structures) in the rural health zones of Katana and Walungu. Methods A cross-sectional survey was conducted from June to September 2017. Consenting respondents comprised 1751 adults. Continuous data were summarized using means (standard deviation) and medians (interquartile range). We used Pearson’s chi-square test and Fisher exact test to compare proportions. Logistic regression was run to assess socio-determinants of health center utilization. Results The morbidity rate of the sample population for the previous month was 86.4% (n = 1501) of which 60% used health centers for their last morbid episode and 20% did not. 5.3% of the respondents patronized prayer rooms and 7.9% resorted to self-medication principally because the cost was low, or the services were fast. Being female (OR: 1.51; p = 0.005) and a higher level of education (OR: 1.79; p = 0.032) were determinants of the use of health centers in Walungu. Only the level of education was associated with the use of health centers in Katana (OR: 2.78; p = 0.045). Conclusion Our findings suggest that health centers are the first recourse for the majority of the population during an illness. However, a significant percentage of patients are still using traditional healers or prayer rooms because the cost is low. Our results suggest that future interventions to encourage integrated health service use should target those with lower levels of education.

scholarly journals Knowledge of Antimalarials and Health Seeking Behaviour of Households in Case of Suspected Malaria in Democratic Republic of the Congo

2021 ◽  
Author(s):  
Nsengi Yumva Ntamabyaliro ◽  
Christian Burri ◽  
Yves Ntamba Lula ◽  
Daniel Isosho ◽  
Aline Biongo Engo ◽  
...  
Keyword(s):  
Secondary School ◽  
Democratic Republic ◽  
Health Centers ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Self Medication ◽  
Level Of Education ◽  
Catholic Religion ◽  
Republic Of The Congo ◽  
Good Behaviour

(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and one urban Health Centers in each of the 11 previous provinces of DRC, all households with a case of malaria in the 15 days prior to the survey were selected. The patient or caregiver (responder) were interviewed. Logistic regression was used to assess predictors of knowledge of recommended antimalarials and good behaviour in case of suspected malaria. (3) Results: 1,732 households participated; about 62% (1060/1721) of the responders were informed about antimalarials, 70.1% (742/1059) knew the recommended antimalarial and 58.6% (995/1699) resorted on self-medication. Predictors of knowledge of antimalarials were education to secondary school or university, information from media and smaller households. Predictors of good behaviour were catholic religion and smaller households. Receiving information from CHW failed to be determinants of knowledge or adequate attitude. (4) Conclusion: malaria control in DRC is hampered by ignorance and non-adherence to national recommendations. These aspects are influenced by unsuccessful communication, size of households and level of education.

scholarly journals Impact of the COVID-19 pandemic and response on the utilisation of health services in public facilities during the first wave in Kinshasa, the Democratic Republic of the Congo

2021 ◽  
Vol 6 (7) ◽  
pp. e005955
Author(s):  
Celestin Hategeka ◽  
Simone E Carter ◽  
Faustin Mukalenge Chenge ◽  
Eric Nyambu Katanga ◽  
Grégoire Lurton ◽  
...  
Keyword(s):  
Time Series ◽  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Infectious Diseases ◽  
Service Use ◽  
Democratic Republic ◽  
Health Service Use ◽  
Outpatient Visits ◽  
Republic Of The Congo

IntroductionHealth service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone.MethodsUsing monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (ie, Gombe vs other health zones).ResultsHealth service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lockdown was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.ConclusionThe COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than prepandemic levels.

scholarly journals Impact of the COVID-19 pandemic and response on the utilisation of health services during the first wave in Kinshasa, the Democratic Republic of the Congo

2021 ◽  
Author(s):  
Celestin Hategeka ◽  
Simone Elyse Carter ◽  
Faustin Mukalenge Chenge ◽  
Eric Nyambu Katanga ◽  
Gregoire Lurton ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Infectious Diseases ◽  
Service Use ◽  
Democratic Republic ◽  
Communicable Diseases ◽  
Health Service Use ◽  
Non Communicable Diseases ◽  
Republic Of The Congo

Introduction: Health service use among the general public can decline during infectious disease outbreaks and has been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) implemented public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone, to mitigate impact of the pandemic. Methods: Using data from the Health Management Information System (January 2018 - December 2020), we evaluated the impact of the pandemic on the use of essential health services (total visits, maternal health, vaccinations, visits for common infectious diseases, and diagnosis of non-communicable diseases) using interrupted time series with mixed effects segmented Poisson regression models during the first wave of the pandemic. Analyses were stratified by age, sex, health facility, and neighbourhood. Results: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for hypertension diagnoses to 39% for diabetes diagnoses. However, reductions were highly concentrated in Gombe (81% decline in total visits) relative to health zones without lockdown. When the lockdown was lifted, total visits, visits for infectious diseases, and diagnoses for non-communicable diseases increased approximately two-fold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected. Conclusion: The COVID-19 pandemic resulted in important reductions in health service utilisation in Kinshasa, particularly Gombe. Lifting of lockdown led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.

scholarly journals Cost of a new method of active screening for human African trypanosomiasis in the Democratic Republic of the Congo

2020 ◽  
Author(s):  
Rian Snijders ◽  
Alain Fukinsia ◽  
Yves Claeys ◽  
Alain Mpanya ◽  
Epco Hasker ◽  
...  
Keyword(s):  
Human African Trypanosomiasis ◽  
Democratic Republic ◽  
Public Health Problem ◽  
Cost Effective ◽  
Active Case Finding ◽  
Active Screening ◽  
Populations At Risk ◽  
Republic Of The Congo ◽  
Cost Effective Alternative ◽  
The Cost

ABSTRACTBackgroundHuman African trypanosomiases caused by the Trypanosoma brucei gambiense parasite is a lethal disease that killed thousands of people at the start of the 20th century. Today, less than 1,000 cases are reported globally, and the disease is targeted for elimination and eradication. One of the main disease control strategies is active case-finding through outreach campaigns. In 2014, a new method for active screening was developed with mini, motorcycle-based, teams. This study aims to compare the cost of two approaches for active HAT screening, namely the traditional mobile teams and mini mobile teams.MethodsWe estimated annual economic costs for the two active HAT screening approaches from a health care provider perspective. Cost and operational data was collected for 12 months for 1 traditional team and 3 mini teams in the health districts of Yasa Bonga and Mosango in the Kwilu province of the Democratic Republic of the Congo. The cost per person screened and per person diagnosed was calculated. Univariate sensitivity analysis was conducted on important cost drivers.ResultsThe study shows that the cost per person screened is lower for a mini team compared to a traditional team in the study setting (US$1.86 compared to US$2.08) as well as in a simulation analysis assuming both teams would operate in a setting with similar disease prevalence.DiscussionActive HAT screening with mini mobile teams has a lower cost and could be a cost-effective alternative for active screening campaigns. Further research is needed to determine if mini mobile teams have similar or better yields than traditional mobile teams in terms of detections and cases successfully treated.AUTHOR SUMMARYHuman African Trypanosomiasis (HAT) used to be a major public health problem in Sub-Saharan Africa, but the disease is becoming less frequent today as a result of sustained control efforts. Currently, the elimination of sleeping sickness is targeted as a public health problem by 2020 with interruption of transmission by 2030. To achieve these targets, a long-term commitment towards HAT control activities will be necessary with innovative disease control approaches accompanied by economic evaluations to assess their cost and cost-effectiveness in the changing context. Today, active case finding conducted through mass outreach campaigns accounts for approximately half of all identified cases in the Democratic Republic of the Congo. However, this strategy has become less efficient, with a dwindling “yield” in terms of the number of identified cases, translating to a higher cost per diagnosed HAT case. Therefore, different approaches to outreach campaigns need to be evaluated with a focus on reaching populations at risk for HAT.This article presents the costs and outcomes of two approaches to active screening: traditional mobile teams and mini mobile teams.This study shows that mini mobile teams could be a cost-effective alternative for active screening with a cost-per-person screened of US$1.86 compared to US$2.08. This approach could increase the screening coverage of populations at risk for HAT that are currently not being reached through the traditional approach. Future research is needed to evaluate the difference in HAT cases identified and treated by both approaches. This would allow a cost-effectiveness comparison of both strategies based on the cost-per-person diagnosed and treated.

scholarly journals Knowledge of Antimalarials and Health Seeking Behaviour of Households in Case of Suspected Malaria in Democratic Republic of the Congo

2021 ◽  
Vol 6 (3) ◽  
pp. 157
Author(s):  
Nsengi Y. Ntamabyaliro ◽  
Christian Burri ◽  
Yves N. Lula ◽  
Daniel Ishoso ◽  
Aline B. Engo ◽  
...  
Keyword(s):  
Secondary School ◽  
Democratic Republic ◽  
Health Workers ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Self Medication ◽  
Level Of Education ◽  
Catholic Religion ◽  
Republic Of The Congo ◽  
Good Behaviour

(1) Background: The Democratic Republic of the Congo (DRC) is heavily affected by malaria despite availability of effective treatments. Ignorance and unrecommended behaviour toward a suspected malaria case in households may contribute to this problem. (2) Method: In communities of one rural and one urban Health Centres in each of the 11 previous provinces of DRC, all households with a case of malaria in the 15 days prior to the survey were selected. The patient or caregiver (responder) were interviewed. Logistic regression was used to assess predictors of knowledge of recommended antimalarials and adequate behaviour in case of suspected malaria. (3) Results: 1732 households participated; about 62% (1060/1721) of the responders were informed about antimalarials, 70.1% (742/1059) knew the recommended antimalarials and 58.6% (995/1699) resorted to self-medication. Predictors of knowledge of antimalarials were education to secondary school or university, information from media and smaller households. Predictors of good behaviour were Catholic religion and smaller households. Receiving information from Community Health Workers (CHWs) failed to be determinants of knowledge or adequate behaviour. (4) Conclusion: malaria control in DRC is hampered by ignorance and non-adherence to national recommendations. These aspects are influenced by unsuccessful communication, size of households and level of education.

scholarly journals Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

2019 ◽  
Author(s):  
Gemma Halliwell ◽  
Sandi Dheensa ◽  
Elisabetta Fenu ◽  
Sue K Jones ◽  
Jessica Asato ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Cost Savings ◽  
Health Service Use ◽  
Potential Cost ◽  
Safety Outcomes ◽  
The Cost ◽  
Domestic Violence And Abuse

Abstract Background Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services. Methods Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services. Results Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,050 per patient per year. This offset the average cost of providing hospital IDVA services. Conclusions Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.

scholarly journals Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse

2019 ◽  
Author(s):  
Gemma Halliwell ◽  
Sandi Dheensa ◽  
Elisabetta Fenu ◽  
Sue K Jones ◽  
Jessica Asato ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Health Service ◽  
Health Services ◽  
Service Use ◽  
Cost Savings ◽  
Health Service Use ◽  
Potential Cost ◽  
Safety Outcomes ◽  
The Cost ◽  
Domestic Violence And Abuse

Abstract Background Domestic violence and abuse damages the health of survivors and increases use of healthcare services. We report findings from a multi-site evaluation of hospital-based advocacy services, designed to support survivors attending emergency departments and maternity services. Methods Independent Domestic Violence Advisors (IDVA) were co-located in five UK hospitals. Case-level data were collected at T1 (initial referral) and T2 (case closure) from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3,544; T2 N = 2,780), used as a comparator. Measures included indicators of sociodemographic characteristics, experience of abuse, health service use, health and safety outcomes. Multivariate analyses tested for differences in changes in abuse, health and factors influencing safety outcomes. Health service use data in the six months pre-and post- intervention were compared to generate potential cost savings by hospital IDVA services. Results Hospital IDVAs worked with survivors less visible to community IDVA services and facilitated intervention at an earlier point. Hospital IDVAs received higher referrals from health services and enabled access to a greater number of health resources. Hospital survivors were more likely to report greater reductions in and cessation of abuse. No differences were observed in health outcomes for hospital survivors. The odds of safety increased two-fold if hospital survivors received over five contacts with an IDVA or accessed six or more resources / programmes over a longer period of time. Six months preceding IDVA intervention, hospital survivors cost on average £2,463 each in use of health services; community survivors cost £533 each. The cost savings observed among hospital survivors amounted to a total of £2,050 per patient per year. This offset the average cost of providing hospital IDVA services. Conclusions Hospital IDVAs can identify survivors not visible to other services and promote safety through intensive support and access to resources. The co-location of IDVAs within the hospital encouraged referrals to other health services and wider community agencies. Further research is required to establish the cost-effectiveness of hospital IDVA services, however our findings suggest these services could be an efficient use of health service resources.

scholarly journals Trends of Maternal Health Service Coverage in the Democratic Republic of the Congo: A Pooled Cross-Sectional Study of MICS 2010 to 2018

2021 ◽  
Author(s):  
Fuyu Guo ◽  
Xinran Qi ◽  
Huayi Xiong ◽  
Qiwei He ◽  
Tingkai Zhang ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Democratic Republic ◽  
Skilled Birth Attendance ◽  
Maternal Health Service ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Birth Attendance ◽  
Republic Of The Congo ◽  
The Impact

Abstract Background Maternal health service is essential for reducing maternal and newborn mortality. However, maternal health service status in the Democratic Republic of the Congo (DRC) remains poorly understood. This study aims to explore the trends of antenatal care (ANC) and skilled birth attendance coverage in the past decade in the DRC.Methods The 13,313 participants were from two rounds of Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics of the Ministry of Planning of the DRC, in collaboration with the United Nations Children’s Fund (UNICEF), in 2010 and 2017-2018. A regression-based method was adopted to calculate the adjusted coverages of ANC and skilled birth attendance. Subgroup analysis based on different socioeconomic status (SES) was conducted to explore the impact of domestic conflicts.Results From 2010 to 2018, the overall weighted ANC coverage declined from 87.3% (95% CI 84.1% to 86.0%) to 82.4% (95% CI 81.1% to 84.0%), while the overall weighted skilled birth attendance coverage increased from 74.2% (95% CI 72.5% to 76.0%) to 85.2% (95% CI 84.1% to 86.0%) in the DRC. The adjusted ANC coverage and adjusted skilled birth attendance coverage both declined in the Kasai Oriental, but both increased in the Nord Kivu and Sud Kivu. In the Kasai region, the largest decline for the adjusted coverages of ANC and skilled birth attendance was found among the poorest women. Nevertheless, in the Kivu region, both the adjusted coverages of ANC and the skilled birth attendance increased for the poorest women. Conclusions With lasting domestic conflicts, there was a systemic deterioration of maternal healthcare coverage in some regions, particularly among people with low SES. While in some other regions, maternal healthcare service was not severely disrupted due possibly to the substantial international health assistance.

scholarly journals Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

2009 ◽  
Vol 3 (1) ◽  
Author(s):  
Sara E Casey ◽  
Kathleen T Mitchell ◽  
Immaculée Mulamba Amisi ◽  
Martin Migombano Haliza ◽  
Blandine Aveledi ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Service Delivery ◽  
Democratic Republic ◽  
Health Service Delivery ◽  
Reproductive Health Service ◽  
Assessment Data ◽  
Facility Assessment ◽  
Republic Of The Congo
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