Scope of Preventative and Promotional Health Care Services Offered by Private Health Care Businesses Owned by Nurses and Physicians in Mbuji Mayi, Democratic Republic of the Congo

Many international health stakeholders have encouraged the creation of private health care businesses (PHCBs) in Africa without suspecting them of any proclivity to engage preferably in conventional fix-it-only-when-it-is-already-broken approaches at the expense of more preventative and promotional health care strategies. Empirical evidence is lacking to measurably apprehend such a proclivity and its correlates. This study seeks to determine the scope of preventative and promotional services (SPPS) delivered by PHCBs and explore the extent to which SPPS could be explained by owners' professional background and by timing of creation. A survey was conducted in July 2010 in Mbuji Mayi. Among other things, data on owners and on involvement (score=1) or not (score=0) of sixty-eight PHCBs in six areas (health education, immunization, prenatal care, well-baby monitoring, home health care and obstetrical care) were collected. A scale measuring SPPS (range 0-6) was created and evaluated in terms of internal consistency (Cronbach alpha =.86). A regression analysis was performed. The average SPPS score is 3.24 (n=41 and S.D.= 2.2). Nurses created 40% and physicians 17.6% of PHCBs. About 61% of sample PHCBs were created in the last ten years. About 25 percent of the variance of SPPS is explained by owners' professional background and timing of creation (Adjusted R Squared=.248). SPPS declines over time and significantly varies across professions. Physician-owned PHCBs have higher scores than nurse-owned PHCBs. There is a need to explore and address the determinants of decline in SPPS offered by newly created PHCBs and of lower SPPS in nurse-owned PHCBs.