This document summarizes a study on access to health services for the elderly in the Democratic Republic of Congo. It finds that the elderly in the DRC generally report poor health due to age and poverty. Accessing health services is very difficult due to financial barriers, long distances to facilities especially in rural areas, and lack of transportation infrastructure and support networks. The conclusion is that health services are largely inaccessible for many elderly Congolese due to limited coverage, destruction of infrastructure from war, and the high cost of care.

1. Accessing health services in the
Democratic Republic of Congo:
Perspectives of the elderly
Ganzamungu Zihindula
Pranitha Maharaj
Maharajp7@ukzn.ac.za

2. Background
 The Democratic Republic of the Congo (DRC) is situated in
central Africa and is the third largest country in Africa.
 The country is vast and rich in natural resources but the
majority of the population lives in poverty.
 Poverty is a major problem in the country with 71.3% of the
Congolese surviving below the income poverty line (UNDP
2010).
 Hunger is a major problem for a large sector of the population.
 The life expectancy remains low at 48 years but there are a
substantial number of older people in the country given the
massive population (UNDP 2010).

3. Background
 For the past several decades the DRC has been characterized
by severe conflict and political upheavals.
 This has had serious implications for the health sector, and
also has negatively impacted on the health of thousands of
civilians.
 The health of older population in the country has also suffered
as a result of decades of armed conflict.

4. Background
 Given the situation in the country it is difficult to come across
reliable data on the health situation of the population,
particularly the older sector.

5. Aim of the study
 The aim of the study is to shed some insights into the health
and health seeking behaviour of the elderly.

6. Methodology
 The study relies on qualitative data that comes from in-depth
interviews.
 20 in-depth interviews

7. Perception of Health
 Almost all the respondents reported poor health, stating that
they suffered from a range of health ailments.
 Men and women associate old age with poor health and they
expect to experience ill-health.
 Some argue that poverty was exacerbating their health
situation.

8. Health Seeking Behaviour
 Interviews revealed the desperate situation of men and women
who are suffering from ill-health in the DRC.
 Their precarious financial situation places them at a great
disadvantage.
 In most cases, access to treatment in the DRC is limited by
financial barriers.
 Without money they will not receive health services.

9. Health Seeking Behaviour
 Accessing health facilities in the rural areas is a huge
challenge.
 The long distance to the health centre is a major barrier to
utilization of health care services.
 Many of the rural areas in particular do not have proper roads
and it is difficult to get around these areas.
 In addition, the trip to the health facility is long and exhausting
for them, especially for the sick and frail.
 Some fear visiting health facilities because of the fear of
physical and sexual violence.
 It was not uncommon for women who were on their way to
markets, churches and hospitals to be become victims of rape.

10. Health Seeking Behaviour
 The lack of government support was perceived as a major
barrier to accessing health care.
 They were not aware of any social grants for the elderly.

11. Conclusion
 Health services are out of reach for many of the elderly.
 There is limited coverage of health services in the DRC.
 In the DRC the rural areas have been most severely affected by
war.
 The war destroyed roads and bridges that ensured easy
access to health centers.
 An important issue to emerge is how the economic situation of
the elderly impacted on their health seeking behaviour.
 Cost is a major barrier to health care utilization.
 In addition, because of their frailty they cannot access health
care services without the support of family and friends.