Contextual factors in the democratic Republic of Congo that facilitate the growth of community based health insurance for access to maternal health care in karisimbi health Zone/North KIVU/RDC

This research aimed to explore the contextual factors in the DRC that facilitate the growth of community based health insurance for access to maternal health care in North Kivu. A qualitative methodological approach was adopted to conduct the field surveys using semi-structured interviews and direct observation techniques. A typical or "purposive" sample was drawn from among the staff working in various community based health insurance organizations operating in the Karisimbi health zone as well as some who work in the Center for risk management and technical support for community based health insurance, a provincial structure responsible for providing technical support for the development of community based health insurance organizations. At the end of the sampling process, 35 individuals participated in the survey. Content analysis was used to generate the results presented in this original article. The research highlighted the general knowledge of different efforts that the government of the Democratic Republic of Congo has already deployed to establish the community based health insurance strategy, as well as the activities and tasks accomplished by the support personnel for the community based health insurance, each according to the list of responsibilities outlined in their job description. It appears that the choice of the community based health insurance as one of the strategies to finance health services in the DRC, the promulgation of laws on the community based health insurance, the advocacy organized within the framework of bilateral cooperation with various international firms and the call for international solidarity, The establishment of the national program for the implementation of community based health insurance as well as the national coordination body aimed at ensuring the monitoring of the implementation of the recommended approaches for the implementation of the package of activities related to community based health insurance reflect sufficiently a very good will to revitalize the implementation of community based health insurance. However, this participation faces multiple problems, including the lack of availability of accompanying measures for the perfect execution of the requirements of the law voted and promulgated, the lack of a circuit for the valorization of data produced by the operational community based health insurance plans, poor cooperation between community based health insurance actors and health care providers in medical training, and the lack of use of standard management tools, To overcome these challenges, the staff working in the management of community based health insurance expressed their wish to see their managers approach the national deputies of their jurisdiction once they are on parliamentary vacation to recommend to them to see how in the next few days they can register the point of wanting to make available to the actors engaged in the implementation of community based health insurance in the Democratic Republic of Congo the document containing the measures of application of the 2017 law on community based health insurance. That the managers see how to get together to set up the official site where the data can be hosted for easy accessibility to all so that it can serve for decision-making at the appropriate time for development purposes or operational research. Organize tripartite meetings of all the support staff of each community based health insurance in order to validate the management tools that are the source of quality in the conduct of the activities of the community based health insurance. This research highlights the evidence of contextual factors that can contribute to improving performance in the implementation of community based health insurance, while showing that there is still a real need to improve certain factors for a full implementation of this strategy. Since the theme was not addressed in its entirety, future research perspectives were recommended.