Tropical Medicine and International Health
Volume 3, Issue 7, 1998, Pages 559-565

How robust are district health systems? Coping with crisis and disasters in Rutshuru, Democratic Republic of Congo (Article)

Porignon D.* , Soron'Gane E.M. , Lokombe T.E. , Isu D.K. , Hennart P. , Van Lerberghe W.
  • a Ctr. Sci. Med. Res. Free Univ. B., Brussels and School of Public Health, Free University of Brussels, Belgium, CEMUBAC Team, Goma, North Kivu, Congo, CEMUBAC, Free University of Brussels, School of Public Health, Route de Lennik 808 (CP 595), 1070 Brussels, Belgium
  • b CEMUBAC Team, Goma, North Kivu, Congo
  • c CEMUBAC Team, Rutshuru Health District, North Kivu, Congo
  • d CEMUBAC Team, Goma, North Kivu, Congo
  • e Ctr. Sci. Med. Res. Free Univ. B., Brussels and School of Public Health, Free University of Brussels, Belgium
  • f Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

Abstract

BACKGROUND Since the eighties, the North Kivu Province socio-economic environment has been deteriorating. This province also faced an influx of Rwandan refugees in July 1994. The objective of the paper is to show how a rural health district has been able to adjust and maintain its medical activities under unfavourable conditions. METHOD Performances of the local health system were assessed through the analysis of routine medical data collected in the Rutshuru Health District (RHD) between 1985 and 1995. Specific data collected during the Rwandan refugee crisis measured the workload of RHD due to the refugees. RESULTS For 11 years, health infrastructures have remained accessible and functional in RHD. The curative utilization and preventive coverage rates increased. Obstetrical activities were intensified from a quantitative as well as from a qualitative point of view. Between July and October 1994, the RHD treated 65 000 cases of various pathological conditions in Rwandan refugees settled outside the camps. This corresponds to 9.3% of consultations for Rwandan refugees settled on RHD's territory and represents a 400% increase in the curative workload for the RHD health services. Human and financial resources remained at a very low level, especially when compared with those available in the camps through relief agencies. CONCLUSION The RHD was severely affected by various stresses but its services managed to provide significant and efficient response to these crises. Health district systems may constitute an effective tool to provide health care under adverse conditions.

Author Keywords

maternal health services Preventive health services Refugees disasters Health services research Democratic Republic of Congo District health system

Index Keywords

maternal care rural area healthcare refugee developing country human Rutshuru health system Democratic Republic of Congo Congo disaster health program female Article major clinical study health care access preventive medicine health care system cesarean section
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0031855666&doi=10.1046%2fj.1365-3156.1998.00263.x&partnerID=40&md5=30ca1f06e78d7bea7f04cf7c05903b62
DOI: 10.1046/j.1365-3156.1998.00263.x
ISSN: 13602276
Cited by: 7
Original Language: English