Budget Alignment of Partners in the Democratic Republic of Congo and Its Impact on the Performance of Health Services

Introduction: Households are the main source and a key player in health financing in the DRC in a proportion of 41% of current health expenditure. Alongside households, the other sources are foreign aid and the State Budget. The general objective of our study was to evaluate the performance of the local health system of Budjala. Methods: This is a cross-sectional study for analytical purposes on the budget alignment of partners in the DRC and its impact on the performance of health services conducted at the Budjala General Reference Hospital from 2013 to 2017 (a 5-year period). Our study population consisted of staff and users of the Reference General Hospital. Results: Our study shows that: the entire state budget was devoted to the payment of the bonus and salary of the staff; the external aid budget was allocated to the financing of human resources through bonuses and training, investment, pharmaceuticals and running costs; the household budget was allocated to finance staff bonuses, investment, pharmaceuticals and running costs. External aid funding accounted for 60.56% of the funding allocated to the Budjala Reference General Hospital from 2013 to 2017. About the performance indicators of the Budjala General Reference Hospital: regarding the supply and use of services, we found a bed occupancy rate below 60%, an average length of stay of 6.8 days, a delivery rate of 91%, a low referral rate, a mortality greater than 48 hours of 3.4%, a postoperative infection rate of 2.4%. In relation to user satisfaction: the satisfaction rate was 92.4% and the dissatisfaction rate 7.6%. Among the causes of dissatisfaction, we note the unavailability of medicines (OR: 10.1; 95% CI: 2.4 - 43.5) and a lack of medical equipment (OR: 8.6; 95% CI: 3.7 - 19.9). Conclusion: External aid represented 60.56% of the funding allocated to the Budjala Reference General Hospital from 2013 to 2017, bed occupancy below 60%, mortality over 48 hours of 3.4%, postoperative infection rate of 2.4%.