Facteurs Associés A La Faible Utilisation De Service De Soins Curatifs Par Les Ménages Dans La Zone De Santé Mikalayi

Abstract

Background : Being in good health is one of the fundamental rights of every human being. The use of health services remains a guarantee for improving the health status of citizens and the development of each nation. Our study focused on the factors associated with the low use of curative care services by households, in the health zone (ZS) of Mikalayi, Kasaï Central Province, in the Democratic Republic of Congo. Indeed, over the past 5 years, we have noted that, in this ZS, the use of health services was less than 0.5 consultations per inhabitant, per year. This result evolved unevenly between 2019 and 2023, respectively: 0.47; 0.43; 0.39; 0.36 and 0.36 consultations per inhabitant, per year. Our objective was to identify the factors associated with this poor performance in the Mikalayi health zone and propose prospects for improvement based on the results obtained. To do this, a cross-sectional analytical study was carried out among 390 households in the ZS Mikalayi. The study was carried out by 6 people including 4 investigators, 1 supervisor, and a coder. It was planned for nine months (from April to December 2023).

Methods: We conducted a cross-sectional analytical study in the Mikalayi ZS on a random sample of 390 households. Using a structured questionnaire, we questioned heads of households or their representatives about the factors that determine (or limit) their poor access to care.

Results: At the end of our survey, we estimated that the proportion of use of health services by households was 26% (95% CI 22.0 - 30.8) and the main determinants were low socio-economic level. -economic (OR3.280 and CI: 1.512 to 7.115) and the size of households with more than 6 members (OR 8.553 and CI4.112 to 17.793).

Conclusion: At the end of our study, we found that the proportion of use of curative care services was 26% in the Mikalayi health zone. Income and household size were main indicators for inaccessibility to curative care services. These 2 factors are likely to be corrected by considering measures targeting: awareness raising for the promotion of family planning, and the establishment of a health insurance/mutual health system in the logic of health coverage universal.