École Régionale de Santé Publique, Université Catholique de Bukavu, Avenue Michombero N°2, Kadutu, Bukavu, Democratic Republic of Congo.
Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium.
BMC Health Serv Res. 2023 Nov 11;23(1):1238. doi: 10.1186/s12913-023-10216-0.
The health system, in the Democratic Republic of Congo, is expected to move towards a more people-centered form of healthcare provision by implementing a biopsychosocial (BPS) approach. It's then important to examine how change is possible in providing healthcare at the first line of care. This study aims to analyze the organizational capacity of health centers to implement a BPS approach in the first line of care.
A mixed descriptive and analytical study was conducted from November 2017 to February 2018. Six health centers from four Health Zones (South Kivu, Democratic Republic of Congo) were selected for this study. An organizational analysis of six health centers based on 15 organizational capacities using the Context and Capabilities for Integrating Care (CCIC) as a theoretical framework was conducted. Data were collected through observation, document review, and individual interviews with key stakeholders. The annual utilization rate of curative services was analyzed using trends for the six health centers. The organizational analysis presented three categories (Basic Structures, People and values, and Key Processes).
This research describes three components in the organization of health services on a biopsychosocial model (Basic Structures, People and values, and Key processes). The current functioning of health centers in South Kivu shows strengths in the Basic Structures component. The health centers have physical characteristics and resources (financial, human) capable of operating health services. Weaknesses were noted in organizational governance through sharing of patient experience, valuing patient needs in Organizational/Network Culture, and Focus on Patient Centeredness & Engagement as well as partnering with other patient care channels.
This study highlighted the predisposition of health centers to implement a BPS approach to their organizational capacities. The study highlights how national policies could regulate the organization of health services on the front line by relying more on the culture of teamwork in the care structures and focusing on the needs of the patients. Paying particular attention to the values of the agents and specific key processes could enable the implementation of the BPS approach at the health center level.
刚果民主共和国的卫生系统预计将通过实施生物心理社会（BPS）方法向更以患者为中心的医疗保健提供方式转变。因此，重要的是要研究如何在第一线医疗保健中实现变革。本研究旨在分析卫生中心在第一线实施 BPS 方法的组织能力。
这是一项混合描述性和分析性研究，于 2017 年 11 月至 2018 年 2 月进行。该研究选择了来自刚果民主共和国南基伍省的四个卫生区的六个卫生中心。基于 15 种组织能力，利用整合护理的背景和能力（CCIC）作为理论框架，对六个卫生中心进行了组织分析。数据通过观察、文件审查和关键利益相关者的个人访谈收集。使用六个卫生中心的趋势分析了治疗服务的年利用率。组织分析呈现了三个类别（基本结构、人和价值观以及关键流程）。
本研究描述了生物心理社会模式下卫生服务组织的三个组成部分（基本结构、人和价值观以及关键流程）。南基伍省卫生中心目前的运作情况显示出在基本结构组成部分的优势。卫生中心具有能够运营医疗服务的物理特征和资源（财务、人力）。在组织治理方面存在弱点，例如在组织/网络文化中分享患者体验、重视患者需求、关注以患者为中心和参与以及与其他患者护理渠道合作方面。
本研究强调了卫生中心实施 BPS 方法的组织能力倾向。研究强调了国家政策如何通过更多地依赖护理结构中的团队合作文化，并关注患者的需求，来规范一线卫生服务的组织。特别关注代理人的价值观和特定的关键流程，可以使 BPS 方法在卫生中心层面得以实施。
