From care services utilization in urban areas to the universal health coverage in the context of the health system in the Democratic Republic of Congo: the case of the city of Goma

Introduction : The organizational model of health in the Democratic Republic of Congo is based on primary health care. Overall, the organization of this system in urban areas still depend on the one of rural areas where public health facilities predominate. Only data from these integates facilities are taken into consideration for the evaluation of utilization services. In this context, in cities where private health facilities proliferate, the level of use is still considered low. Methodology : Data were analyzed in relation to the curative service utilization of all functional health facilities in the eastern DRC city of Goma in order to estimate the overall health coverage for the year 2017 and its contribution in monitoring progress towards universal health coverage. Results : Overall utilization of curative services was 0.61 new case per capita. In this global utilization, the contribution of integrated health facilities in the health system was only 18.7% (n = 579,555). More than 75% of this utilization was covered by private health facilities. But in thses private health facilities, quality was poor. Conclusion : In urban areas, most medical supply service was provided by private health facilities, their non consideration does not make it possible to correctly assess either their use by the population nor the progress towards universal health coverage. In a context of increasing urbanization, the accreditation of private health facilities could be an innovative strategy for their integration, improve quality and good monitoring progress towards universal health coverage.