Recorded presentation

Emile Bongo Beni, MD MPH, Health Program / Infectious Disease, USAID, 198 Isiro Avenue, Kinshasa Gombe, Kinshasa Gombe, Congo-Kinshasa, (243) 81-700-5701, ebongo@usaid.gov, Franklin Baer, DrPH, MHS-TM, Baertracks, 326 7th St., Harrisonburg, VA 22802, and Pascal Munkatu, MPH, Administration, SANRU III Basic Rural Health Project, Ave. de la Justice, Kinshasa-Gombe, Congo-Kinshasa.

Since 1975, health zones have been the building blocks of the decentralized health system of DR Congo. Given the problems of the past decade, it is remarkable that health zones continue to exist and function. Yet, a 2001 WHO/UNICEF report noted that “The health zone system . . . is possibly the only system in the country still recognizable as a nation-wide quasi-state structure . . . and even with critically little or no support, it commands allegiance and support from health workers.”

Health zones continue to provide the best long-term perspective for health development in DR Congo. The “middle-out” development of health zones is based on several important principles:

1. A health zone is a well-defined geographical area comprising a referral hospital, satellite health centers and community action groups. A typical health zone in DR Congo includes a hospital, 20 health centers, 200 villages to serve 150,000 people.

2. Health Zones are geographically defined from the bottom-up with respect to the existing infrastructure of governmental and NGO managed hospitals. This consensus-building process firmly establishes “ownership” and leadership of health zones at the local level.

3. Planning and management of health zones are strongly decentralized in collaboration with communities. This helps to avoid a duplication of services between public and private health facilities and improves development of strategies specific to local communities.

4. Approximately half of Congo’s 400+ health zones are managed or co-managed by NGOs, especially those of the protestant and catholic health services.

Learning Objectives: At the conclusion of this presentation, the participants will be able to

• Identify the components of a decentralized health zone;
• Define what is meant by “co-management” of health zones; and
• List four reasons why health zones are the foundation for rebuilding the health system in DR Congo.

Keywords: Community Health Programs, Public/Private Partnerships

Related Web page: minisanterdc.cd

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation