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This study, based on a survey conducted in 2008, examines how combining microcredit, microinsurance, and health care provision can improve access to quality care in the health zone of Bandalungwa, in Kinshasa. The bivariate analysis showed a significant association between increased purchasing power and earnings (p = 0.001), between earnings and savings (p = 0.000), and between health insurance and improved access to health care. These results show that 68.8% of borrowers reported an increase in their purchasing power, of whom 82% reported profits. Those with savings were 24.7 times more likely to purchase health insurance than those without; and 72% of those who regularly made health insurance payments improved their access to care. Combining microcredit, health microinsurance, and health care can improve access to quality health care at lower cost. This suggests that health insurance could usefully be integrated into the primary health-care system. © 2015, John Libbey Eurotext. All rights Reserved.

Ilunga-Ilunga F.,Institute Superieur Des Techniques Medicales Of Kinshasa | Ilunga-Ilunga F.,Free University of Colombia | Leveque A.,Free University of Colombia | Dramaix M.,Free University of Colombia
Sante Publique | Year: 2015

Introduction: The objective of this study was to determine the source of health care funding for heads of households related to the management of severe malaria in children admitted to a Kinshasa reference hospital. Methods: This cross-sectional study was conducted on 1,350 hospitalised children under the age of 15 years treated for severe malaria in Kinshasa reference hospitals from January to November 2011 and the heads of households of these children. Results: Only 46% of heads of households reported having sufficient funds directly available in the household budget. The remaining 54% had to call upon external sources of funding (sale of assets, loans, pawning goods). The use of a loan tended to increase significantly mainly for households with a low (adjusted odds ratio = 6.2), and intermediate socioeconomic status (adjusted odds ratio = 3.8) and for households working in the informal sector (adjusted odds ratio = 2.5). Similarly, the sale of assets was more frequently reported for households working in the informal sector (adjusted odds ratio = 2.4) ) and for female heads of households (adjusted odds ratio = 3.9). Conclusion: The management of severe malaria is a burden on household income. The majority of heads of households concerned needs to use external funding sources. A State subsidy for this management would help to reduce the risk of debt and sale of assets, especially for the poorest households.

Manzambi Kuwekita J.,University of Liège | Manzambi Kuwekita J.,Institute Superieur Des Techniques Medicales Of Kinshasa | Bruyere O.,University of Liège | Guillaume M.,University of Liège | And 2 more authors.
Sante Publique | Year: 2015

Analysis of national health insurance accounts in the Democratic Republic of Congo (DRC) clearly shows the importance of international sanitary aid, particularly for the funding of general referral hospitals, the management of inpatients with AIDS, administration of health zones and funding of preventive care providers. It The targeted changes described in this article could possibly optimize the efficiency of international aid for the DRC population, mainly for disorders considered to be a health care priority (i.e. malaria, AIDS, tuberculosis) as well as in the fight against malnutrition. Recommendations target the implementation of procedures for control of food chain security, changes in lifestyle and dietary habits of the population but also comprise extensive restructuring of the health care administration. A dramatic change of the structure in charge of drug distribution as well as eradication of the transfer of part of public health structure income to public health administrative personnel could result in the allocation of significant funds to the fight against the most important diseases. Better collaboration between the various departments in charge of health care professional training, together with enhanced responsibility of health care personnel is essential. Independent and respected non-governmental organizations should be involved in an audit process, targeting all aspects of the current DRC health system. Eventually, in an equal opportunity perspective, taking into consideration the very high degree of poverty of DRC inhabitants, implementation of health insurance programmes, use of generic drugs and generalization of micro-credit initiatives should also be implemented. © S.F.S.P. Tous droits réservés pour tous pays.

PubMed | Institute Superieur Des Techniques Medicales Of Kinshasa
Type: Journal Article | Journal: Journal of infection in developing countries | Year: 2014

Malaria remains a real problem of public health. Its hospital care generates important expenditures for affected households. The present study aimed to estimate direct and indirect costs of severe child malaria in reference hospitals in Kinshasa.This prospective study included 1,350 children under 15 years of age suffering from severe malaria. The study was performed between 1 January and 30 November, 2011. Data were collected in nine reference hospitals. The studied parameters were direct pre-hospital costs, direct hospital costs, and indirect costs. Costs were assessed from the household point of view.Median costs associated with the disease ranged from 114 USD in confessional hospitals to 173 USD in state hospitals and 308 USD in private hospitals. Direct pre-hospital median costs ranged between 3 and 11 USD. Direct hospital costs reached 72 USD in confessional hospitals, 139 USD in state hospitals, and 254 USD in private hospitals. Indirect costs ranged from 22 USD in state hospitals to 30 USD in confessional hospitals and 46 USD in private hospitals, regardless of the status of the accompanying parent or guardian. Factors explaining the variability of costs were the neurological form of malaria, indirect recourse to hospital, socioeconomic level, type of prescribing person, childs status upon leaving the hospital, and childs transfusion status.The care of severe child malaria appeared to be expensive in private and state hospitals. A state subsidy of health care and regulation of the private sector would contribute to the reduction of malarias financial impact.

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