2.4. ROLE OF THE STATE IN THE SECTOR OF HEALTH
Generally, the expenditure of health amounts between 13 and
15% of the world income. In 2005, they amounted with more than 1.700 billion
dollars, which represents at least 13 % of world income. Only extent of the
expenditure which the State devotes to health made that it is absolutely
essential to include/understand the effect of the policy of the governments on
pubic health. The role of the State varies from one country to another. Three
reason of an economic nature justify and direct the action of the State,
namely:
1. The poor always do not have the means of obtaining the
clean care of health to improve their productivity and their good - to be.
The
authorities can make move back poverty while investing for
pubic health.
2. Certain interventions of health of authentic public goods
or create importance positive externalities. The market private would produce
only little of it.
3. As the operation of the markets of health and the sickness
insurance has weaknesses, the State can improve the good - to be by improving
operation of these markets.
A good policy of health takes account of the differences in
attention of the diseases. It is effective if it accroit the good - to be
population by an improvement of its health, by a greater consumer satisfaction
or by a reduction of the total cost of the services compared to what it would
be if the State did not intervene.
2.5. TYPES OF MEDICAL SYSTEM MEDICO
In RDC we have two types of system, where on with dimensions
formal system representing the official organization and other side the
abstract system which moreover appears better organized that the formal
system.
2.5.1. Formal system
As mentioned above, it is the official structure which
organizes the system of care of health according to the desire of the public
authority. It is made that for a certain time, this official structure is not
any more with measurement to ensure with effectiveness the objectives which are
assigned to him by the public authority. Today, this structure is characterized
by a advanced dilapidation of the infrastructures, equipment and systematic
leakage of the executives towards the sectors abstract.
The buildings which shelter the central services of the
Ministry for the Public health are in general in bad state not maintained. On
the level of Kinshasa, the Capital of the RDC, one can record some
installations which resist such as the University Private clinics of Kinshasa,
the General Hospital; of reference of Kinshasa, the Private clinic Ngaliema,
the Pediatry of Kalembelembe... there are also others which die under the
obliging eye of the authority.
We quote the hospital of Kitambo, the Private clinic Kinoise,
the hospital complex King Baudouin 1st.If in Kinshasa, there are installations
which have a degree of advanced dilapidation, that in is it on the level of the
interior of the country? Indeed, inside the country certain Centers of Health
are very dilapidated and make care almost ineffective. These hospitals
which had an initially social objective became truths districts
business where doctors and the whole of the personnel do not have decent
fees.
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