title: [Stakeholder representations of the role of the intermediate level of the DRC health system].
abstract: BACKGROUND
  Intermediate health care structures in the DRC were designed during the setting-up of primary health care in a perspective of health district support. This study was designed to describe stakeholder representations of the intermediate level of the DRC health system during the first 30 years of the primary health care system.
  
  
  METHODS
  This case study was based on inductive analysis of data from 27 key informant interviews..
  
  
  RESULTS
  The intermediate level of the health system, lacking sufficient expertise and funding during the 1980s, was confined to inspection and control functions, answering to the central level of the Ministry of health and provincial authorities. Since the 1990s, faced with the pressing demand for support from health district teams, whose self-management had to deal with humanitarian emergencies, the need to integrate vertical programmes, and cope with the logistics of many different actors, the intermediate heath system developed methods and tools to support heath districts. This resulted in a subsidiary model of the intermediate level, the perceived efficacy of which varies according to the province over recent years.
  
  
  CONCLUSIONS
  The "subsidiary" model of the intermediary health system level seems a good alternative to the "control" model in DRC.
authors.forename: Jean Bosco Kahindo
authors.initials: JB
authors.lastname: Mbeva
authors.forename: Hermès
authors.initials: H
authors.lastname: Karemere
authors.forename: Carole
authors.initials: C
authors.lastname: Schirvel
authors.forename: Denis
authors.initials: D
authors.lastname: Porignon
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D015023:Democratic Republic of the Congo; D006801:Humans; D017146:Models, Organizational; D011320:Primary Health Care / Q000458:organization & administration* / Q000639:trends