2.7. FINANCING OF THE SECTOR OF HEALTH IN RDC
The country has passed through a dimensional crisis multi for
several decades. This crisis started during the Seventies continued at the
Nineties and worsened with the international financial crisis of 2007,
transformed into economic crisis, and social crisis.
From the economic point of view, there is to it quasi
paralysis of the basic essential economic activity, with like consequence, a
budget deficit growing, a capital flight, a devalorization of the national
currency, an imbalance of the balance of payments, a high rate of unemployment,
a fall of the production, insufficiency of income, an excessive debt, a growing
loss of the purchasing power of the population.
As regards the social aspects the basic public services such
as housing, the education and the care of health are not ensured any more in a
satisfactory way. At present, serious indices indicate that health in RDC did
not profit from the adequate strategies of financing and is today at the base
of cératines against performance justifying the installation of reforms
an exhaustive list of these against-performance could arise in these term:
The share of the budget allocated with the health, which was
4,7% average between 2003 and 2006 and very weak. Certain countries make
already an effort to increase this share. In Mozambique, for example, the
public expenditure of health increased in 1992 and 1993, within the framework
of a program of reform economic vaster and Mauritania committed itself
appreciably increasing the envelope of health in 1992 and 1996. It is not the
case in RDC, the expenditure of health decreased throughout these quoted crises
Ci-high.
It is deduced from this table 3, that from 2003 to the 2006,
budgetary share allocated with health varies from 4.90% to 4.03%, which is
lower than the standard suggested by the WHO which is about 10 to 15%.Following
this situation, we notice that they are the consumers of care of health which
supports them even this load.
The RDC endorsed the objectives of Millennium for the
Development which to consist with:
- To reduce by 3/4 maternal mortality from here 2015;
- To reduce by 2/3 the mortality of the children by less than 5
years from here 2015;
- To stop and reverse the tendencies of the propagation of the
VIH/SIDA from here 2015.
The engagement of the Government in this field resulted in the
allowance of the significant resources to the sector of Health. Thus, within
the framework of the budget arranged 2004 and 2005, it gave the priority to the
expenditure of the social sector. The appropriations relating to the
expenditure of fight against poverty in the social sector accounted for 31% of
the total Budget evaluated to 528 billion Congolais Francs. On this amount,
5,6% are 29,7 billion Congolais Francs were assigned to the sector health,
which accounts for 1,2% of the nominal GDP of 2004.The budget
appropriations referring to the fight against paludism are
difficult to determine.
As regards financing, the medical history of the RDC appoints
4 times to know:
- The colonial period, characterized by budgets of health
sufficient financed primarily by the Treasury with the support of the private
sector and the religious confessions;
- The period of after independence, (1960-1979) during the
which political disturbances and the socio-economic crisis causing an
increasingly drastic thinning down of contribution of the government;
- The period known as of "the golden age" of primary care of
health (1982-1988) during which country received a flood of external resources
against balancing the negative effects of the nuisance of the State;
- The period of return of darkness (1990-1997)) characterized
by a quasi complete absence of contribution of the public sector to the
financing of health and the suspension of the bilateral co-operations.It is as
from this period that the sector of health began its self-financing.
To be viable, the system of financing of health must be
conceived so as to meet the need for the population.
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