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The Role of the Private Sector in Improving the Performance of the Health System in the Democratic Republic of Congo

Paper | Brunner, Bettina Marie; Combet, Virginie; Callahan, Sean; Holtz, Jeanna; Mangone, Emily; Barnes, Jeff; Clarence, Cathy; Assi, Auguste; Gober, Stephanie

May 29,2019

The private health sector is an important player in the DRC’s health system, but the extent of its contribution remains largely unknown. Private providers, especially faith-based organizations (FBOs), grew in scale during the late 1990s and early 2000s to fill gaps that emerged in the public health sector as a result of political and civil destabilization. As the government sought to reestablish itself and improve health outcomes, it recognized the importance of private providers and sought to integrate them into the larger health system—the private sector is now mentioned as a key partner in several MSP strategies, policies, and plans. However, public–private engagement for health remains nascent, with the notable exception of FBOs. Efforts by the central level to improve engagement have been slow as the government simultaneously seeks to decentralize the health system to provincial and lower levels of government. Overlapping areas of responsibility between these levels, combined with financial and human resource deficits, as well as limited data about who and where the private sector is, have all further decelerated efforts to engage and regulate the private sector. The private health sector itself faces numerous constraints related to the availability of commodities, shortages of adequately trained staff, and financial affordability of private health care. Furthermore, continued political uncertainty has deterred increased corporate investment in the health system. Despite these obstacles, there are numerous opportunities for the DRC’s government and donors to better leverage private actors and improve health outcomes