FBOs and the

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FBOs and the Ministry of Health in DR Congo
by Leon Kintaudi
ECC-DOM
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Protestant Church of Congo (ECC)

• ECC includes 64 protestant communities
• ECC member communities own and manage more than
  80 hospitals and 600 health centers
  
• ECC manages 59 of Congos 306 health zones
• (Catholics manage 89 health zones)

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Public vs. Private Sectors
Public Sector Not-for-Profit
Private Sector For-Profit
Church-Managed Health Services ??
In many countries Church-managed health services
are considered private sector competitors to the
MOH.
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Public, Private FBO Sectors
FBO-Managed Private Sector Not-for-Profit
Public Sector Not-for-Profit
Private Sector For-Profit
In Congo, the MOH delegates management of many
health zones to Church-managed health services.
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Catholic Bishop, ECC Director with Governor of
Bas Congo
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FBO Contributions in policy development for
human resources
Since the beginning of primary health care
activities, ECC has played a major role in
planning and implementing policies together with
MOH.
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Examples of ECC MOH Collaboration

• Organization of a national Alma Ata workshop
  (1975)
  
• Creation of pilot health zones between 1976-1982
• 70 of the first 100 HZs were created by churches
  (1992-84)

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1975 National Workshoporganized by the Churches

• Agreed on a strategy for co-management of
  health services from Government and Church
  reference hospitals.
  
• Adopted concepts of decentralized Health Zones
  and integrated medicine (primary health care).

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The 400 Hospitals in Congo (c. 1960)
In 1975 the MOH began transforming 400 scattered
hospitals into decentralized Health Zones.
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Pilot Health Zones (1975-1981)
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Health Zones (1982)
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Health Zones (1984)before delimitation of Health
Zones
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Health Zones (1984)after delimitation of Health
Zones
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Typical Health Zone
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More Church Initiatives

• ECC participated in the 1985 Mbanza Ngungu
  conference for new PHC orientations
  
• ECC played a major role in the delimitation of
  515 new zones through SANRU III (2002-03)
  
• SANRU III organized a national conference and
  served as pilot program in adoption
  Community-Based IMCI (2003-05)

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2003 SANRU National ColloquiumRebuilding PHC in
DRC
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ECC, SANRU III Policy Making

• Organized two national conferences to introduce
  ITNs (2004)
  
• Initiated a new technical tool for HIV patient
  which was adopted by PNLP in 2005
  
• Elaboration of new guide lines for nutrition
  activities (with UNICEF PRONANUT)

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HIV/AIDS Family Planning

• SANRU III project played a major role in
  assisting MOH with MAP (2002-2003)
  
• SANRU III
• Advance Africa
• held a national
• conference (2004)
• to reposition
• Family Planning
• in DR Congo.

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Contributions in Human Resource Development

• ECC was the first to train nurses on the job and
  has produced the best in the country
  
• ECC runs many of DRCs nursing schools
• SANRU I/II sponsored doctors for MPHs. Many have
  played a major role in PHC.
  
• ECC and SANRU III have trained 3,962 health
  personnel (nurses, doctors, administrators)

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Training of Nurses
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On the job training at Moanza hospital
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Nurses Training (Nsona Mpangu HZ)
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Training in Vanga HZ (2002-2003)
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Family physician training

• ECC is pioneering training family physicians in
  with MEDUNSA (Medical University of S. Africa).
  
  
• Doctors receive MFam Med degree after 4 years of
  training.

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Surgery Rotation at Vanga hospital
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Public Health School in Kinshasa

• ECC through SANRU helped create the school public
  health at UNIKIN (State University of Kinshasa)
  
• To better equip Health Zone Medical Directors as
  primary health personnel, SANRU I, II and III
  supported over 100 doctors for this special
  training.

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ECC Health Professionals Retention
There is a big problem in DR Congo with
- Retention of well train personnel
- SANRU III trained 27 MDs at the SPH, but only
17 returned to their HZs. - Most were lost to
intl organizations and other countries, e.g.,
South Africa
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Mechanisms for Retention by ECC

• Primes to health workers
• Housing
• Specialty training for physicians
• Means of transport if needed
• Learning tools, Internet access, etc.

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Vanga Learning and Information Center
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Houses built for doctors in Vanga
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Rebuilding Health in Congo is an essential
collaboration between FBOs and MOH

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Thank you very much for listening and for your
patience!