Intermediate health system level support to health district: Perceptions of health district teams in North Kivu, eastern DRC

Introduction: In connection with the reform of the intermediate level of the health system in the DRC, this article describes the perceptions of health district teams, regarding to intermediate health level support, in North Kivu province. Methodology: This descriptive cross-sectional study conducted a self-administered questionnaire survey of senior staff in 34 health districts in North Kivu. The collected data was encoded and analyzed using SPSS version 26 software. Results: More than 85% of health district managers (29/34 districts) view positively the support and coaching at the intermediate level, in terms of the adequacy of the accompanying object, the gradient of the competences of the supervisors, the capacity building, the support for problem-solving and the progress on the path of revitalization of health districts. On the other hand, these perceptions are nuanced about the availability of framers, the frequency of accompanying visits, the juxtaposition of these visits on other activities and the effects on the use of services and the protection of users from financial risks. These perceptions do not vary by gender, age, occupational categories, and seniority in function and within the health district (p>0.05). Discussion and conclusion: These results show the value of more coherence, proactivity and responsiveness in support and reform of the intermediate level, to strengthen its impact on the performance of health district teams.