Transcript Churches and Health Care in DR Congo

Churches
and Health
Care in
DR Congo
by Leon Kintaudi
ECC-DOM Medical Director
Presentation Outline
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ECC-DOM and IMA World Health
A Brief History of Health Zones
The Role of Faith-Based Health Services
Challenges and Future Perspectives
ECC-DOM and
IMA World Health
ECC-DOM
Protestant Church of Congo Medical Office
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61 member communities
80 hospitals
600+ health centers
70 co-managed health
zones (see map)
IMAWH is a member association of twelve
U.S. church relief and development agencies:
– Adventist Development Relief Agency
– Lutheran World Relief
– American Baptist Church USA
– Mennonite Central Committee
– Christian Church (Disciples of Christ
– Presbyterian Church (USA)
– Church of the Brethren General Board
– United Church of Christ
– Church World Service & Witness
– Episcopal Relief and Development
– United Methodist Church, Global Min.
– Vellore Christian Med College
The IMA World Health Mission
To provide essential products and services for
emergency, health and development programs
of interest to member agencies which serve
people in need without regard to ethnicity,
creed, color, gender, national origin
or religious or political affiliation.
ECC-DOM and IMA World Health
Operational Strengths
 Collaboration with MOH
 Procurement
 Project management
 Networking
 Financial management
A Brief History of
Health Zones in
the DR Congo
The Congo Health System…
is well designed to provide
comprehensive primary health care
through decentralized health zones
co-managed, in many cases,
by churches & NGOs.
Health Zone Administrative Structure
Central office :
Health Zone
Management
Committee
Hospital
Director
Supervision
Health Center
Management Committee
Health
Post
Referral
Health
Center
Hospital Management
Committee
Referral
H.Center
Referral
Referral
Hospital
Referral
Components of
a Health Zone
in DR Congo
- 125,000 people
- 20 Health Centers
- 1 Ref. hospital
A Typical Health Zone
The Purpose of Health Zones is to
provide Primary Health Care
 Curative Care… treating the fever
 Preventive Care… sleeping under a bednet
 Promotional Care… draining swampy areas
The challenge is to maintain
a balance of resources
1975 National Workshop
Adopted concepts of decentralized
Health Zones and primary health care.
 Agreed on a principle of co-management
by Government and church hospitals.
Pilot Health Zones (1981)
Health Zones (1982)
1984 – before HZ delimitation
75% of
the first
85 health
zones
were
developed
around
church
hospitals
1984 – after HZ delimitation
75% of
the first
85 health
zones
were
developed
around
church
hospitals
The Role of
Faith-Based Health Services
in DR Congo
The Roles of FBOs in Health Care
1)
2)
3)
4)
5)
6)
Pioneering of community health services
Provision of PHC services at community level
Provision of Referral Services (hospitals)
Co-Management of Health Zones (~180)
Management of Regional Services (depots)
Management of National Projects (SANRU)
Co-management by FBOs & NGOs
 ~50% of health services provided by FBOs / NGOs
 ~50% of health facilities are owned by FBOs
 HZs are MOH “owned” with FBO co-management
Public vs. Private
Co-Management
35% of the current 515 health zones
are co-managed by FBOs
SANRU Rural Health
HZ Development Assistance
• 1981-86 SANRU I
50 HZs
• 1986-91 SANRU II
100 HZs
• 1991-00 ECC/DOM
12-36 HZs
• 2000-06 SANRU III & PMURR
75 HZs
• 2006+
AXxes, PMURR, Global Fund 128 HZs
AXxes
PMURR
Abbott
SP+
GF
MRP
DEVRU
Health Development in 128
of DRC’s 515 health zones
SANRU the project has evolved
into SANRU the Program
ECC-DOM’s partnership with
IMA World Health manages $10 million
of assistance to health zones each year
ECC / IMAWH
SANRU Program Objectives
 Integrated Primary Health Care
especially for Mothers and Children
 Health Systems Strengthening
of decentralized health zones,
especially those co-managed by FBOs
(including community & congregation
Actions through SANRU
• Strengthening Integrated PHC
(pre-natal clinic, well child clinic, family
planning, post-natal care, vaccination, etc)
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Health education / C-IMCI
Water and Sanitation
Malaria prevention & treatment
Training health teams
Essential drugs supply
Health zone development
Vaccinations
Curative care
Prenatal care
Well Child Care
Preventive care
Blood Safety
Essential Drug Supply
Water and Sanitation
Training Health Teams
SANRU Trends in Services
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Curative Care
CPN
Assisted briths
CPS
2001
2002
2003
2004
2005
2006
Family Planning
40000
35000
30000
25000
20000
15000
10000
5000
0
2002
2003
2004
2005
Couple Years Protection
2006
Vaccination
Coverage
Malaria: Fever during last 14 days
among households with and without ITNs
60%
50%
54%
40%
44%
30%
20%
35%
22%
22%
10%
14%
0%
Pregnant Women
Children 0-11
months
Without Bed Nets
Children 12-59
months
With Bed Nets
n=514
Water, Sanitation & Hygiene
2163 Springs capped – Access increased 32%
Waterborne disease decreased by 30%
70%
60%
50%
40%
30%
20%
10%
0%
2002
2003
2004
Access to water
2005
Challenges and
Future Perspectives
Challenges
• Sustainability of HZs after projects end.
• Stability of the country
• Control of endemic diseases like Malaria,
ARI, HIV/AIDS, Tuberculosis and Malnutrition
• Knowledge and understanding of illness by
the population
Large families (average 7)
Housewife and provider
Producer
Financial Person
Second Rank Citizen
Male attitude
FUTURE PERSPECTIVES
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Continue present activities in health zones
Continue collaboration with the MOH
Improve training (ST & LT) for health personnel
Improve income activities for HZs & population
Emphasize Maternal, Child & new born care
Identify funding for newly formed HZs and health
zones without development partners.
Santé Pour
Tous et
Par Tous