Thesis Miss Michou Kafuku

Operational comparative analysis of the reference in urban and rural-health zone of Kisanga and Kapolowe in the DRC. By Michou Kafuku Mikombe

The reference system is the interface between the decentralizing trends of the first line of health care and the centralizing tendencies of the general referral hospital for continuity of care. This study carried out in August 2016 compared the main factors that interfere with the operation of the reference and counter-reference system in urban (Kisanga) and rural (Kapolowe).

The results indicate overall, an organizational dysfunction of the reference system in both media is observed, especially the holding of reference tickets, hospitals do not counter-refer patients, lack of flowcharts in health centers and medium Adapted for the evacuation of referred patients.

In the Kapolowe Rural Health Zone, we noted fewer problems with the provision of food by the referring patients, contrary to the experience of the patients referred to in the Kisanga health zone on this subject and which reduces the acceptability of Strategy by this category of patients.

Possible solutions include sensitizing the population, considering positive discrimination in the provision of care and making accessible transportation suitable for emergency evacuation.

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