Mopene Jean Louis, Molima Christian, Kahindo Jean Bosco M, Makali Samuel, Karemere Hermès
Ecole Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu (UCB), Bukavu.
Afr J Prim Health Care Fam Med. 2020 Dec 15;12(1):e1-e9. doi: 10.4102/phcfm.v12i1.2534.
Reform and Performance of the Provincial Health Inspectorate and the Provincial Division of Health of South Kivu in the Democratic Republic of Congo.
The intermediate level incorporated both the Provincial Health Inspectorate (IPS) and the Provincial Health Division (DPS) of Health. The new constitution of 2006 gave impetus to decentralisation, which became effective in 2015. The reform introduced at the intermediate level clearly separated the IPS and the DPS. This article assesses the effect of this reform on the performance of IPS and DPS in South Kivu, Democratic Republic of Congo.
The study is evaluative before and after and covers the period from 2012 to 2017. It uses mixed methods: three techniques were used to collect data including observation, document review and individual interviews. The analysis of the quantitative data concerned the evolution of the indicators; that of qualitative data was carried out by themes from two theoretical models: the ministerial functional framework and the 'Strengths, Weaknesses, Opportunities and Threats' analysis framework (SWOT analysis). Scores were assigned to each managerial function according to their level of performance for better comparison.
After the reform, a decline in the performance score of activities devolved to IPS is noted, mainly due to the low funding of activities. On the other hand, in the DPS, the evolution of the score is favorable, because of the strong support given to the reform at this level by the partners and the government. The alignment of partners to a single contract for funding DPS activities is observed. The weak financing of the health sector by the government remains a weak point, however, and the brain drain a threat to institutional sustainability. The introduction of the single financing contract constitutes an opportunity to improve the performance of the provincial management team.
The study shows the improvement in the performance of managerial functions of the DPS and the regression to the IPS. The low funding of IPS by the Congolese government could jeopardise the reform.
刚果民主共和国南基伍省卫生监察局和省卫生司的改革与绩效
中间层级整合了省卫生监察局（IPS）和省卫生司（DPS）。2006年的新宪法推动了权力下放，于2015年生效。在中间层级推行的改革明确划分了IPS和DPS。本文评估了此项改革对刚果民主共和国南基伍省IPS和DPS绩效的影响。
该研究为前后评估研究，涵盖2012年至2017年期间。采用混合方法：运用了三种数据收集技术，包括观察、文件审查和个人访谈。定量数据分析涉及指标的演变；定性数据分析则依据两个理论模型的主题进行：部级职能框架和“优势、劣势、机会和威胁”分析框架（SWOT分析）。根据各管理职能的绩效水平分配分数，以便更好地进行比较。
改革后，下放给IPS的活动绩效得分下降，主要原因是活动资金不足。另一方面，在DPS，得分的演变是有利的，因为合作伙伴和政府在这一层级对改革给予了大力支持。观察到合作伙伴对为DPS活动提供资金的单一合同保持一致。然而，政府对卫生部门的资金投入薄弱仍是一个弱点，人才外流对机构可持续性构成威胁。引入单一融资合同是提高省级管理团队绩效的一个机会。
该研究表明DPS管理职能的绩效有所改善，而IPS则出现倒退。刚果政府对IPS的资金投入不足可能会危及改革。
