Mutual Health Insurance Model: Strategic Axis for Access to Health Care for Households in the DRC. Case Analysis of the Mutuelle De Santé De Kinshasa

This paper analyzes the issue of access to health care for households with health care needs while facing several constraints. According to the World Health Organization (WHO), the risk of a child dying before his or her fifth birthday is 8 times higher in Africa than in Europe. Rich countries have an average of nearly 90 nurses and midwives per 10,000 people, while in low-income countries, the ratio of health care personnel is barely more than 5 per 10,000 people. Inequality in access to health care is highly dependent on location. In the DR Congo, obstacles to accessing health care include: difficulties in finding certain medicines, stock-outs, lack of money and the high cost of care. Despite the low level of household income, the financing for health care access is on average 14.28% by the public authorities, 39.43% by the rest of the world (external financing) and 39.17% by households according to the national health accounts. It appears crucial to provide concrete and adapted solutions to this population which needs to access care on a daily basis when they are in a vulnerable situation. Our estimates show that none of the variables taken into account have a significant influence at the 5% threshold on access to health care for members of the Kinshasa mutual health insurance scheme, which means that membership of a mutual health insurance scheme is a valid way of accessing health care in low-income countries such as the DRC. The comparative analysis of behavior-based approach by the Institute of Medicine (IOM), helped us reflect on the mutual insurance and access to health care in the DRC