Original Research

Contrat unique, une approche innovante de financement du niveau intermédiaire du système de santé en République Démocratique du Congo : processus et défis de mise en œuvre

Ghislain Bisimwa, Samuel L. Makali, Hermes Karemere, Christian Molima, Raphael Nunga, Alain Iyeti, Faustin Chenge
African Journal of Primary Health Care & Family Medicine | Vol 13, No 1 | a2869 | DOI: https://doi.org/10.4102/phcfm.v13i1.2869 | © 2021 Samuel Lwaboshi Makali | This work is licensed under CC Attribution 4.0
Submitted: 13 December 2020 | Published: 06 December 2021

About the author(s)

Ghislain Bisimwa, École Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, République Démocratique du Congo; and, Centre de Connaissance en Santé en R.D Congo, Kinshasa, République Démocratique du Congo
Samuel L. Makali, École Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, République Démocratique du Congo; and, Hôpital Provincial Général de Référence de Bukavu, Bukavu, République Démocratique du Congo
Hermes Karemere, École Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, République Démocratique du Congo
Christian Molima, École Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Bukavu, Bukavu, République Démocratique du Congo
Raphael Nunga, Direction d’Études et de Planification, Ministère de la Santé Publique, Kinshasa, République Démocratique du Congo
Alain Iyeti, Direction d’Études et de Planification, Ministère de la Santé Publique, Kinshasa, République Démocratique du Congo
Faustin Chenge, Centre de Connaissance en Santé en R.D Congo, Kinshasa, République Démocratique du Congo; and, École de Santé Publique, Faculté de Médecine, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo

Abstract

Basket fund, an innovative approach for intermediate health system level financing in the Democratic Republic of Congo: Implementation process and challenges.

Background: Universal health coverage should allow countries to establish a financing strategy in order to guarantee the health of the population.

Aim: Our objective was to describe the process and preliminary results of the implementation of the basket fund approach as a mode of financing the intermediate level (provincial health divisions) of the Congolese health system.

Setting: The study was conducted in the provincial health divisions (PHDs), representing the intermediate level of the health system in the Democratic Republic of Congo, where the basket fund approach has been implemented

Methods: We conducted a mixed-methods convergent study as part of the evaluation of the basket fund approach in the Democratic Republic of Congo, five years after its introduction (2014–2019). Data was collected through a document review and individual interviews by telephone. A descriptive analysis of the quantitative data was conducted using Statistical Package for Social Sciences (SPSS) version 24 software. The qualitative data were analysed by thematic analysis using a pre-established thematic framework.

Results: The implementation of the basket fund approach was effective in some (PHDs) (53.8% in 2016). The operating costs of the PHDs varied according to the size, density and number of health zones covered. In the PHDs where the basket fund was operational, this approach appeared to contribute to improved planning and management in the use of resources, the partnership between technical and financial partners (TFPs and PHDs) and incentives for the performance of PHD agents.

Conclusion: In the DRC, the basket fund approach has contributed to improved collaboration between donors in the health sector and facilitated the decentralisation of funding planning to the provincial level.


Keywords

Financing; health system; basket fund; intermediate level; DRC

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Crossref Citations

1. Ensuring leadership at the operational level of a health system in protracted crisis context: a cross-sectional qualitative study covering 8 health districts in Eastern Democratic Republic of Congo
Rosine N. Bigirinama, Samuel L. Makali, Mamothena C. Mothupi, Christian Z. Chiribagula, Patricia St Louis, Pacifique L. Mwene-Batu, Ghislain B. Bisimwa, Albert T. Mwembo, Denis G. Porignon
BMC Health Services Research  vol: 23  issue: 1  year: 2023  
doi: 10.1186/s12913-023-10336-7