Tchouaket Éric, Sia Drissa, Karemere Hermès, Kapiteni Woolf, Robins Stephanie
Université du Québec en Outaouais, Sciences infirmières, Saint-Jérôme, Canada.
Catholic University of Bukavu, Regional School of Public Health, Bukavu, République démocratique du Congo.
Sante Publique. 2024 Apr 5;36(1):135-149. doi: 10.3917/spub.241.0135.
Due to the Democratic Republic of the Congo’s (DRC) precarious health system that provides only limited access to health care, the European Union, via Memisa Belgium, implemented a program to strengthen provision of and access to health care (known as PRO DS) in the provinces of Kongo Central and Ituri. This program took a holistic approach, seeking to improve equitable access and combat malnutrition.
To measure the program’s social return on investment and to estimate the cost per capita and effectiveness per euro invested (efficiency), a 61-month (1 July 2017 to 31 July 2022) cost-effectiveness evaluation with a societal perspective was carried out. The double-difference method was used to compare the results of PRO DS and non-PRO DS zones. The social return on investment was assessed via the ratio of effectiveness to costs.
Analyses revealed the program cost between 3.72 and 3.96 euros per capita per year (2022) in Kongo Central, and between 3.12 and 3.36 euros in Ituri. Importantly, it was cost-effective in the areas of reproductive health, nutrition, and the use of health and nutrition services.
The program’s strong nutritional component and overall holistic vision may explain why it was so efficient. PRO DS stands out from other programs that focus solely on one specific problem or population. Although the program has some limitations, it would be worthwhile for the government to invest in it.
由于刚果民主共和国的卫生系统不稳定，仅能提供有限的医疗服务，欧盟通过比利时的Memisa在刚果中部省和伊图里省实施了一项加强医疗服务提供和获取的计划（称为PRO DS）。该计划采取整体方法，旨在改善公平获取医疗服务的机会并对抗营养不良。
为衡量该计划的社会投资回报率，并估计人均成本和每欧元投资的效益（效率），从社会角度进行了为期61个月（2017年7月1日至2022年7月31日）的成本效益评估。采用双重差分法比较PRO DS区和非PRO DS区的结果。通过效益与成本的比率评估社会投资回报率。
分析显示，2022年，刚果中部省该计划的人均年度成本在3.72欧元至3.96欧元之间，伊图里省在3.12欧元至3.36欧元之间。重要的是，该计划在生殖健康、营养以及卫生和营养服务利用等领域具有成本效益。
该计划强大的营养组成部分和整体的全面愿景或许可以解释其为何如此高效。PRO DS有别于其他仅专注于一个特定问题或人群的计划。尽管该计划存在一些局限性，但政府对其进行投资是值得的。
