Strengthening the health system

Programme description

Title: Strengthening the health system in DR Congo
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Democratic Republic of the Congo
Lead executing agency: Ministère de la Santé Publique
Overall term: 2005 to 2016


In most parts of the country, the population of DR Congo is exposed to considerable health risks. Besides deficits in the treatment and prevention of widespread diseases, such as malaria, tuberculosis, sleeping sickness and other poverty-related diseases, few services are available for family planning, sexual and reproductive health, or HIV/AIDS. Although there is extensive international support for the health sector, maternal and infant mortality rates in the country are still among the highest in Africa. The Congolese Ministry of Health has devised a health development plan, to be put into effect between 2012 and 2015.

Around 6.4 million people live in the regions of South Kivu and Kwango. Most of them are poor and many are women and children below the age of five. There are also women, men and children who are the victims of sexual violence, and people living with HIV.


The efficiency and efficacy of the health system in DR Congo have improved, and steps have been taken to establish peripheral management structures.


The project works with its partners at provincial and district levels to establish integrated mechanisms for preventing the spread of endemic diseases. It is also developing improved health services, which it is easier for the population to access. At the same time, the team is strengthening the partners’ management structures so that they are better able to coordinate the activities of international organisations and donors. Many different national and international organisations are involved in the fight against sexualised violence. The coordination of these efforts also benefits from the project’s support for management structures at national and provincial levels.

The project provides training and advice on organisational development and management to assist the support and management unit, the directorate for studies and planning, and the directorate of primary health structures. It furthermore encourages and reinforces partnerships between the private sector, the public health care sector and the international donor community.


The provincial government of South Kivu now integrates the international partners’ activities in its annual operational plans. So far, more than 90 per cent of all health centres in South Kivu have participated in a systemic health-improvement approach. Proposals for improvements are incorporated in annual operational plans, and the partners now include the concept of integrated quality improvement in their supervision procedures.

The government has introduced a flat-rate payment system for remunerating medical services according to cases. This makes it easier for a larger number of people to afford treatment, while the costs remain transparent. Between 2005 and 2015, there was an almost 90 per cent increase in the number of births overseen by health professionals.

Members of the Ministry of Health’s support and management unit now attend three-monthly meetings to coordinate their outgoings and the use of resources. It is now easier to control and evaluate the financial commitments.

Regular coordination meetings are held between the donors to ensure a collective strategy in the fight against sexualized violence. In its donor coordination activities, the South Kivu government has benefited from the project support, which includes assistance to the Division for Gender, Family, Children.