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Impact of the cost of the care of health of menages in Kinshasa

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par Jérémy MESKIA MAVANGA
Université de Kinshasa RDC - Licence 2010
  

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Chapter Second: POLICY AND SYSTEM OF HEALTH IN RDC

2.1. POLICY OF HEALTH IN RDC

The historical evolution of the system of health of the RDC, like that of other African States, is marked by the institutional character and the initiative of the authorities. The medical situation of the RDC knew variable levels since the colonial period so far. With the paddle of independence, the medical policy was primarily centered on the remedial medicine, through medico-surgical centers and satellite dispensaries.

With the changes socio-policies of the years 1960 and 1970, the system of health knew deep disturbances. The population could reach the rare care of health only thanks to the efforts of several speakers who started respectively to try out policies of Community health in Bwamanda (Province of Ecuador), in Kisantu (Province of Low-Congo), in Kasongo (Province of Maniema) and Vanga (Province of Bandundu).

These experiments will be determining and will influence the policy of health of the RDC and whose evolution led to the adhesion of the RDC to the African charter of development aiming at Health for all by 2015 and adopted the strategy of the Primary Care of Health (SSP) like basic strategy. In order to support geographical accessibility with the SSP, the country was subdivided in 306 Zones of Health (ZS) in 1985 then in 515 in 2004.

The ZS serve each one on average 100.000 inhabitants in rural medium and 150.000 in urban environment. Each ZS includes/understands a central Office of ZS (BCZS), a general Hospital of reference (HGR) and 15 to 20 Centers of Health (CS) serving each one a Surface of Health (ACE), emanation of the local community.

The policy which to date governs the sector of the Health of the years 1978 has as a fundamental option "the satisfaction of the needs for health of all the population that it is in urban environment or rural medium". It aims:

- Education concerning the problems of health and the methods of fight;

- The promotion of good nutritional conditions;

- Material and infantile protection including family planning;

- The fight counters the epidemics and great endemics;

- Vaccination counters the infectious diseases;

- Treatment of the diseases and the current lesions;

- supply healthy water and measurements of basic cleansing; - Supply of the essential drugs;

- Mental health;

- The administrative Process;

- The formation continues.

2.2. STRUCTURE OF THE MEDICO-MEDICAL SYSTEM

At June 30, 1960, the RDC had a significant and sophisticated medical organization. At that time the medical system congolais was very well structured with academic installations which made the pride of the country the shortly after independence.

For proof, the population of certain African countries like Zambia, the African Southern Republic, Kenya not to quote that these came to be made look after in hospitals of the place. Since, we note an opposite movement. It is now congolais them which will be made look after in these countries and lend services in this field. What proves with sufficiency that there is a problem in the organization of our medical system?

Before 1960, the medical departments of the territory congolais were ensured by triple organization:

- Medical departments of the government;

- Private companies;

- Medical philanthropic works.

2.2.1. Services of the government

They were directed by the Doctor as a head and included/understood five great subdivisions:

- Services of Medical care

- Services of the medical Laboratories;

- Service of Supply drugs, products and materials of all the governmental formations and to approve were ensured by the pharmaceutical medico- central Deposit (DCMP);

- Service of medical Teaching;

- Service of Public health.

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