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An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services

Access to universal health coverage is a fundamental right that ensures that even the most disadvantaged receive health services without financial hardship. The Democratic Republic of Congo is among the poorest countries in the world, yet healthcare is primarily made by direct payment which renders...

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Autores principales: Tchouaket, Eric, Karemere, Hermes, Sia, Drissa, Kapiteni, Woolf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686929/
https://www.ncbi.nlm.nih.gov/pubmed/37804377
http://dx.doi.org/10.1007/s44197-023-00147-8
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author Tchouaket, Eric
Karemere, Hermes
Sia, Drissa
Kapiteni, Woolf
author_facet Tchouaket, Eric
Karemere, Hermes
Sia, Drissa
Kapiteni, Woolf
author_sort Tchouaket, Eric
collection PubMed
description Access to universal health coverage is a fundamental right that ensures that even the most disadvantaged receive health services without financial hardship. The Democratic Republic of Congo is among the poorest countries in the world, yet healthcare is primarily made by direct payment which renders care inaccessible for most Congolese. Between 2017 and 2021 a purchasing of health services initiative (Le Programme de Renforcement de l’Offre et Développement de l’accès aux Soins de Santé or PRO DS), was implemented in Kongo Central and Ituri with the assistance of the non-governmental organization Memisa Belgium. The program provided funding for health system strengthening that included health service delivery, workforce development, improved infrastructure, access to medicines and support for leadership and governance. This study assessed the social and health impacts of the PRO DS Memisa program using a health impact assessment focus. A documentary review was performed to ascertain relevant indicators of program effect. Supervision and management of health zones and health centers, use of health and nutritional services, the population’s nutritional health, immunization levels, reproductive and maternal health, and newborn and child health were measured using a controlled longitudinal model. Positive results were found in almost all indicators across both provinces, with a mean proportion of positive effect of 60.8% for Kongo Central, and 70.8% in Ituri. Barriers to the program’s success included the arrival of COVID-19, internal displacement of the population and resistance to change from the community. The measurable positive impacts from the PRO DS Memisa program reveal that an adequately funded multi-faceted health system strengthening program can improve access to healthcare in a low-income country such as the Democratic Republic of Congo.
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spelling pubmed-106869292023-12-01 An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services Tchouaket, Eric Karemere, Hermes Sia, Drissa Kapiteni, Woolf J Epidemiol Glob Health Research Article Access to universal health coverage is a fundamental right that ensures that even the most disadvantaged receive health services without financial hardship. The Democratic Republic of Congo is among the poorest countries in the world, yet healthcare is primarily made by direct payment which renders care inaccessible for most Congolese. Between 2017 and 2021 a purchasing of health services initiative (Le Programme de Renforcement de l’Offre et Développement de l’accès aux Soins de Santé or PRO DS), was implemented in Kongo Central and Ituri with the assistance of the non-governmental organization Memisa Belgium. The program provided funding for health system strengthening that included health service delivery, workforce development, improved infrastructure, access to medicines and support for leadership and governance. This study assessed the social and health impacts of the PRO DS Memisa program using a health impact assessment focus. A documentary review was performed to ascertain relevant indicators of program effect. Supervision and management of health zones and health centers, use of health and nutritional services, the population’s nutritional health, immunization levels, reproductive and maternal health, and newborn and child health were measured using a controlled longitudinal model. Positive results were found in almost all indicators across both provinces, with a mean proportion of positive effect of 60.8% for Kongo Central, and 70.8% in Ituri. Barriers to the program’s success included the arrival of COVID-19, internal displacement of the population and resistance to change from the community. The measurable positive impacts from the PRO DS Memisa program reveal that an adequately funded multi-faceted health system strengthening program can improve access to healthcare in a low-income country such as the Democratic Republic of Congo. Springer Netherlands 2023-10-07 /pmc/articles/PMC10686929/ /pubmed/37804377 http://dx.doi.org/10.1007/s44197-023-00147-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Tchouaket, Eric
Karemere, Hermes
Sia, Drissa
Kapiteni, Woolf
An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title_full An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title_fullStr An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title_full_unstemmed An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title_short An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services
title_sort analysis of the social impacts of a health system strengthening program based on purchasing health services
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686929/
https://www.ncbi.nlm.nih.gov/pubmed/37804377
http://dx.doi.org/10.1007/s44197-023-00147-8
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