From Insecurity to Health Service Delivery: Pathways and System Response Strategies in the Eastern Democratic Republic of the Congo

Chiara Altare; Vito Castelgrande; Maphie Tosha; Espoir Bwenge Malembaka; Paul Spiegel

doi:10.9745/GHSP-D-21-00107

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Pathways Through Which Insecurity Affects Health Service Delivery and Quality in North and South Kivu Provinces, Democratic Republic of the Congo

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TABLE 1.

Participants in In-Depth Interviews and Focus Group Discussions in Analysis of Insecurity and Health Service Provision and Quality in North and South Kivu Provinces, Democratic Republic of the Congo

In-Depth Interview Participants by Affiliation	North Kivu	South Kivu
Ministry of Health (DPS/MCZ)	4	5
Nongovernmental organization	4	6
United Nations agency	2	2
Health care providers	12	12
Total	22	25
Focus Group Discussion Participants
Community health workers	17 (40% Male; 60% Female)	20 (75% Male; 25% Female)

Abbreviations: DPS, Division Provinciale de Santé (Provincial Health Division); MCZ, Médicin Chef de Zone (Chief Medical Officer of the health zone).

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TABLE 2.

Drivers and Mediators of the Links Between Insecurity and Health Service Provision and Quality in North and South Kivu Provinces, Democratic Republic of the Congo

Level	Mediators	Drivers
Level	Mediators	Violence	Mobility/ Access	Resources
Health system	Health care workforce availability	X	X	X
	Drugs and equipment availability	X	X	X
	Delays in reaching care		X
	Transportation costs		X
	Training and supervision		X
	Delays in implementing activities		X
Individual	Stress	X
Individual	Reduced motivation			X