Original Research

Les médecins prestataires à la première ligne des soins dans la ville de Kisangani en République Démocratique du Congo : vers une typologie

Samuel I. Bosongo, Faustin C. Mukalenge, Albert M. Tambwe, Bart Criel
African Journal of Primary Health Care & Family Medicine | Vol 13, No 1 | a2617 | DOI: https://doi.org/10.4102/phcfm.v13i1.2617 | © 2021 Samuel BOSONGO, Faustin Chenge, Albert Mwembo, Bart Criel | This work is licensed under CC Attribution 4.0
Submitted: 15 June 2020 | Published: 06 September 2021

About the author(s)

Samuel I. Bosongo, Department of Public Health, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
Faustin C. Mukalenge, School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo; and, Centre de Connaissances en Santé au Congo, Kinshasa, Democratic Republic of the Congo
Albert M. Tambwe, School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
Bart Criel, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

Abstract

The first-line physicians’ practice in Kisangani city in Democratic Republic of Congo: Towards a typology.

Background: In the Democratic Republic of the Congo (DRC), for a number of years, there has been a spontaneous and growing phenomenon of physicians operating at the front line of the health system, while this role is traditionally devolved to nurse-practitioners. This phenomenon does not align with the current health policy.

Aim: The aim of this paper is to develop and discuss the main types of frontline physicians in the city of Kisangani.

Setting: We conducted a descriptive cross-sectional study in two urban districts in the city of Kisangani.

Methods: The study population consisted of all first-line health facilities that employed at least one physician. The construction of a typology of first-line physicians consisted of three stages: identification and definition of relevant dimensions of analysis; grouping cases based on empirical data; and analysis of significant relationships and establishment of the typology itself.

Results: An involvement of physicians in healthcare delivery at the first line was observed in 60% of all first line facilities in the two urban districts. Two main types of first-line physicians were identified: firstly, and by large the most prevalent one (96% of cases), the ‘hospital-like physician’, and secondly, the much less frequent type of the ‘supervision physician’.

Conclusion: The involvement of physicians in first line healthcare is today a growing phenomenon in the DRC, especially in urban areas. The most dominant expression of this phenomenon is a transposition of the hospital-based physician model to the first line healthcare services, which thereby jeopardizing the specificity of first line healthcare.


Keywords

physicians; first line healthcare facilities; health district system; typology; Democratic Republic of Congo

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Crossref Citations

1. The role of provincial health administration in supporting district health management teams in the Democratic Republic of Congo: eliciting an initial programme theory of a realist evaluation
Samuel Bosongo, Zakaria Belrhiti, Faustin Chenge, Bart Criel, Yves Coppieters, Bruno Marchal
Health Research Policy and Systems  vol: 22  issue: 1  year: 2024  
doi: 10.1186/s12961-024-01115-9