Evaluation of the impact of the single contract and the provincial approach in the implementation of the health system reform at intermediate level in upper Uele

Introduction: The right to health is guaranteed by the Constitution of the Democratic Republic of Congo. The Health Promotion Fund created in DR C is financed by public authorities, community contributions, national and international solidarity, approved partners and innovative financing. Methodology: This is an analytical, retrospective, cross-sectional study. An inductive approach was used, with recourse to the survey method. This facilitated the collection of information on the knowledge, attitudes and practices of strategies (effects/impacts) on health system reform, the single contract and the provincial approach. The qualitative survey used an active participatory method. Thus, the use of an attitude questionnaire or opinionnaire as an investigative tool seemed the logical way to gather information on the opinions, interests, values and attitudes of the interviewees. Documentary analysis enabled us to collect other information to complement that gathered by the survey. Results: After analyzing the data, we arrived at the following results: 1. the main reasons for implementing the reform are: pooling of resources to support activities (54.8%); decentralization of funding negotiation points and health functions from central to provincial level (47.6%); strengthening the capacities and skills of the Division's agents (41.7%) and avoiding the retention of funding at national coordination level (28.6% of cases). 2. compliance with and monitoring of the reform are not fully respected in the Haut-Uélé health province (78.6%). Conclusion: Not all Technical and Financial Partners have yet aligned themselves with the single contract approach, and continue to fund activities (Provincial Health Division Offices and Programs) in isolation.