Bosongo Samuel I, Mukalenge Faustin C, Tambwe Albert M, Criel Bart
Department of Public Health, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.
Afr J Prim Health Care Fam Med. 2021 Sep 6;13(1):e1-e8. doi: 10.4102/phcfm.v13i1.2617.
The first-line physicians' practice in Kisangani city in Democratic Republic of Congo: Towards a typology.
In the Democratic Republic of the Congo (DRC), for a number of years, there has been a spontaneous and growing phenomenon of physicians operating at the front line of the health system, while this role is traditionally devolved to nurse-practitioners. This phenomenon does not align with the current health policy.
The aim of this paper is to develop and discuss the main types of frontline physicians in the city of Kisangani.
We conducted a descriptive cross-sectional study in two urban districts in the city of Kisangani.
The study population consisted of all first-line health facilities that employed at least one physician. The construction of a typology of first-line physicians consisted of three stages: identification and definition of relevant dimensions of analysis; grouping cases based on empirical data; and analysis of significant relationships and establishment of the typology itself.
An involvement of physicians in healthcare delivery at the first line was observed in 60% of all first line facilities in the two urban districts. Two main types of first-line physicians were identified: firstly, and by large the most prevalent one (96% of cases), the 'hospital-like physician', and secondly, the much less frequent type of the 'supervision physician'.
The involvement of physicians in first line healthcare is today a growing phenomenon in the DRC, especially in urban areas. The most dominant expression of this phenomenon is a transposition of the hospital-based physician model to the first line healthcare services, which thereby jeopardizing the specificity of first line healthcare.
刚果民主共和国基桑加尼市一线医生的实践：迈向一种类型学
在刚果民主共和国（DRC），多年来，在卫生系统一线工作的医生出现了一种自发且不断增长的现象，而这一角色传统上是由执业护士承担的。这种现象与当前的卫生政策不符。
本文旨在构建并讨论基桑加尼市一线医生的主要类型。
我们在基桑加尼市的两个城区开展了一项描述性横断面研究。
研究人群包括所有至少雇佣一名医生的一线卫生机构。一线医生类型学的构建包括三个阶段：确定并定义相关分析维度；根据实证数据对病例进行分组；分析显著关系并建立类型学本身。
在两个城区的所有一线机构中，60%观察到有医生参与一线医疗服务。确定了两种主要类型的一线医生：首先，也是最普遍的一种（96%的病例），即“医院式医生”，其次，是频率低得多的“监督医生”类型。
如今在刚果民主共和国，尤其是在城市地区，医生参与一线医疗服务是一种日益增长的现象。这种现象最主要的表现是将基于医院的医生模式转移到一线医疗服务中，从而危及一线医疗服务的特殊性。
