Original Research

Réforme et performance de l’Inspection de la santé et de la Division de la santé au Sud-Kivu en République Démocratique du Congo

Jean Louis Mopene, Christian Molima, Jean Bosco M. Kahindo, Samuel Makali, Hermès Karemere
African Journal of Primary Health Care & Family Medicine | Vol 12, No 1 | a2534 | DOI: https://doi.org/10.4102/phcfm.v12i1.2534 | © 2020 Jean Louis Mopene, Christian Molima, Jean Bosco M. Kahindo, Samuel Makali, Hermès Karemere | This work is licensed under CC Attribution 4.0
Submitted: 14 May 2020 | Published: 15 December 2020

About the author(s)

Jean Louis Mopene, Ecole Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu, Congo, the Democratic Republic of the
Christian Molima, Ecole Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu, Congo, the Democratic Republic of the
Jean Bosco M. Kahindo, Faculté de Médecine, Université Officielle du Ruwenzori, Butembo; ULB Coopération, Goma, Congo, the Democratic Republic of the
Samuel Makali, École Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of Congo, Congo; and, Médecine Interne, Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu, Congo, the Democratic Republic of the
Hermès Karemere, École Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu, Congo, the Democratic Republic of the


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Abstract

Reform and Performance of the Provincial Health Inspectorate and the Provincial Division of Health of South Kivu in the Democratic Republic of Congo.

Background: The intermediate level incorporated both the Provincial Health Inspectorate (IPS) and the Provincial Health Division (DPS) of Health. The new constitution of 2006 gave impetus to decentralisation, which became effective in 2015. The reform introduced at the intermediate level clearly separated the IPS and the DPS. This article assesses the effect of this reform on the performance of IPS and DPS in South Kivu, Democratic Republic of Congo.

Methodology: The study is evaluative before and after and covers the period from 2012 to 2017. It uses mixed methods: three techniques were used to collect data including observation, document review and individual interviews. The analysis of the quantitative data concerned the evolution of the indicators; that of qualitative data was carried out by themes from two theoretical models: the ministerial functional framework and the ‘Strengths, Weaknesses, Opportunities and Threats’ analysis framework (SWOT analysis). Scores were assigned to each managerial function according to their level of performance for better comparison.

Results: After the reform, a decline in the performance score of activities devolved to IPS is noted, mainly due to the low funding of activities. On the other hand, in the DPS, the evolution of the score is favorable, because of the strong support given to the reform at this level by the partners and the government. The alignment of partners to a single contract for funding DPS activities is observed. The weak financing of the health sector by the government remains a weak point, however, and the brain drain a threat to institutional sustainability. The introduction of the single financing contract constitutes an opportunity to improve the performance of the provincial management team.

Discussion and Conclusion: The study shows the improvement in the performance of managerial functions of the DPS and the regression to the IPS. The low funding of IPS by the Congolese government could jeopardise the reform.


Keywords

Reform; Decentralization; Health system; Performance; South Kivu; Democratic Republic of Congo

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