Lessons learned from 40 years of developing health systems and universal health care with faith-based networks in DR Congo

In 1975, the MOH of Zaire (now DR Congo) and its faith-based partners established the vision to collaboratively develop a decentralized primary health care system. That vision, implemented, in part, through the SANRU Basic Rural Health project, led to 306 decentralized health zones (HZs) with 50% managed by faith-based partners. SANRU’s approach to “Health for All and by All” increased PHC access in project-assisted HZs from 15% (1982) to 50% (1987). Today, that system has grown to 516 health zones.

Over the years DRC’s decentralized HZ system has endured significant and continuing geographic, infrastructural, political, and post-conflict obstacles. More recently, that system, coupled with renewed efforts to achieve UHC, has achieved significant increases in access to and utilization of key health services, (e.g., immunization coverage for DPT3 is currently more than 90%).

This presentation will identify key factors, events and lessons learned that contributed to developing and sustaining DR Congo’s decentralized health zone (HZ) system as a platform to achieve UHC. For example:

-          Bottom-up development of geographically-flexible health zones;

-          Pioneering and precedent-setting roles by faith-based managed HZs;

-          HZs as a “middle-out” development platform;

-          Affiliation of HZ management teams to reference hospitals; and

HZs as a sustainability factor during times of conflict.