Contribution à l'évaluation du Plan National du Développement Sanitaire recadré 2019-2022 : Cas des Cliniques Universitaires de Kinshasa en 2021

The objective of the Framework National Plan for Health Development of the Democratic Republic of the Congo (P.N.D.S. 2019-2022) is to increase the coverage of services and access to quality health care, as well as their use by the population with equity and financial protection. The overall objective of this study is to assess whether the objectives of quality, fairness and financial protection have been achieved effectively. After analyses, the results showed that the Plan is effective for the quality of care but not for the equity and social protection of the population in the following ways: (1) Quality of care: The average patient stay at the University Clinics in Kinshasa is 11 days, reflecting a good quality of care, with a normal average of 15 to 20 days. (2) Financial protection: The financial burden on the income of direct payers remains excessive, which is 31,9794 times greater than their capacity to contribute. Instead of reducing the burden from 41% to 35% from 2016 to 2022 as envisaged by the Plan, the study finds a high burden of 3,1979% beyond Congolese contributing capacity. In other words, the average Congolese has to spend 20% of his monthly income representing his contributive capacity for 31,9794 months, or two years, 3 months and 29 days, in order to be able to pay his health care debts fully without this burden disrupting his normal lifestyle. As in practice, this possibility of debt scaling is not offered to direct payers, three alternatives appear to them to solve their problems: either they resort to impoverishing loans, or they decide to sell their real estate, or it is still the escape or escape. (3) Social equity: Among the direct paying patients in difficulty with paying, i.e. concerned about debt collection services, 70.3% were socially vulnerable, including children aged 0-5 years (38.1%), women who gave birth and were giving birth after childbirth (24.3%), and older persons over 65 years of age (7,5%). Non-vulnerable, on the other hand, were only 29.7%. Thus, vulnerable payers-direct are the ones that are the most counted among patients in difficulty paying for health care compared to non-vulnerable (29.7%<70.3%). Keywords: P.N.S.D. 2019-2022, evaluation, University Clinics of Kinshasa.