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Impact of the cost of the care of health of menages in Kinshasa

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Université de Kinshasa RDC - Licence 2010

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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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