1. Africa Christian Health Associations’
Platform,
7th Biennial Conference
February 2015
Nairobi - Kenya
SANRU - Presentation
Denis Matshifi, MD, MPH
Healthcare in Conflict and Crisis Settings
DRC
2. • SANRU= Soins de santé primaires en Milieu
Rural (in short: SANTE RURAL)
• Nature: National NGO and Faith Based
Organization
• Mission:
Contributing in collaboration with the
Government to:
Initiate and Execute activities that improve
health and global wellbeing of Congolese
population.
SANRU
6. Multi & Bilateral
Coopérations cut off
National Health
Strategic Plan
National Health
Development Plan &
Proposed Low on UC
BACKGROUND
Political
Crisis &
Rebellion
7. The Congo Health System
Well designed to provide
comprehensive primary health care
through decentralized health zones
co-managed, in many cases, by
churches & NGOs.
9. Co-management by FBOs and NGOs
50% of Health Services provided by FBOs / NGOs
50% of Health Facilities owned by (FBOs)
50% of Health Facilities owned by Gvt and Private
HZs are MOH “owned” with FBO co-management
The DR Congo Health System
Public vs. PrivateCo-Management
10.
11. Actions through SANRU (1)
Actions aimed to ensure:
• Access to health care
• Availability of services
• Community mobilization and involvement for
ownership
• Free health care for all preventative services
12. Actions are based on the Minimum Package of Activities
(PMA) for the HC and Complementary Package of activities
of the Hospital, approved by MOH
• Revitalizing Primary Health Care services
(pre-natal clinic, well child clinic, family planning,
post-natal care, vaccination, etc…)
• Health education / C-IMCI
• Water and Sanitation
• Training of health teams
Actions through SANRU (2)
13. • Training of Community structures members
(Community Health Committee, Community
Volunteers)
• Essential drugs supply
• Gold chain Equipment and fuel
• Health zone development
• Minor rehabilitation of facilities
• Payment of performance incentive to HZ teams and
HC staff (not based on indicators but outputs)
• Support (fees) to national and provincial
(intermediate) teams for formative supervision of the
HZ.
Actions through SANRU (3)
15. • Lack of Government leadership
• Vertical funding (some donors)
• Geographic targeting by donors without
harmonization with MOH and Implementing FBO or
NGOs
• Compliance of free service delivery by facility
personnel
• Sustainability of health zones activities after project is
finished
• Staff instability (turn over for better salary)
• Political instability of the Country
• Knowledge and understanding of illness by the
population
• Women’s conditions
Challenges & Difficulties
21. Opportunities
Existence of well defined health care system
Coexistence between NGOs and Government
Existence of government policies and
procedures
Global awareness
Community implication
22. KEYS FOR SUCCES
Working with and strengthening FBOs, NNGOs
and CBOs that have permanent contact with
communities
Aligning on and working to reinforce government
health policies
Training and reinforcing national staff specific
competencies and qualifications
Having donors’ confidence
Be Innovative and competitive