title: Assessment of health service delivery capacities, health providers' knowledge and practices related to type 2 diabetes care in Kinshasa primary healthcare network facilities, Democratic Republic of the Congo.
abstract: BACKGROUND
  Democratic Republic of the Congo (DRC) is experiencing an increase in the morbi-mortality related to Non Communicable Diseases (NCD). The reform of DRC health system, based on Health District model, is needed in order to tackle this public issue. This article used 2006 International Diabetes Federation (IDF)'s guidelines to assess the capacities of health facilities belonging to Kinshasa Primary Health Care Network (KPHCN) in terms of equipments, as well as the knowledge, and the practice of their health providers related to type 2 diabetes care.
  
  
  METHODS
  A multicentric cross-sectional study was carried in 18 Health Facilities (HF) of KPHCN in charge of the follow-up of diabetic patients. The presence of IDF recommended materials and equipment was checked and 28 health providers were interviewed about their theoretical knowledge about patients' management and therapeutic objectives during recommended visits. Chi square test or Fisher exact test was used to compare proportions and the Student t-test to compare means.
  
  
  RESULTS
  The integration of NCD healthcare in the KPHC network is feasible. The majority of HF possessed IDF recommended materials except for the clinical practice guidelines, urinary test strips, and monofilament, available in only one, two and four HF, respectively. KPHCN referral facilities had required materials for biochemical analyses, the ECG and for the fundus oculi test. Patients' management is characterized by a lack of attention on the impairment of renal function during the first visits and a poor respect of recommended practices during quarterly and annual visits. A poor knowledge of the reduction of cardiovascular risk factors-related therapeutic objectives has been also reported.
  
  
  CONCLUSIONS
  The capacities, knowledge, and practice of T2D care were poor among HF of KPHCN. The lack of equipment and training of healthcare professionals should be supplied even to those who are not medical doctors. Special attention must to be put on the clinical practice guidelines formulation and sensitization and on supervision.
authors.affiliation: Internal Medicine Service, Friendship Sino-Congolese hospital, Kinshasa, Democratic Republic of Congo. rkapongo@yahoo.fr.|Department of Internal Medicine, University Clinics of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo. rkapongo@yahoo.fr.
authors.forename: Remy Y
authors.initials: RY
authors.lastname: Kapongo
authors.affiliation: Kinshasa School of Public Health, School Public Health, Faculty of Medicine, University of Kinshasa, Po Box 11850, Kinshasa 1, DR, Congo. aimelulebo@yahoo.fr.
authors.forename: Aimée M
authors.initials: AM
authors.lastname: Lulebo
authors.affiliation: Kinshasa School of Public Health, School Public Health, Faculty of Medicine, University of Kinshasa, Po Box 11850, Kinshasa 1, DR, Congo. ericmafuta2@gmail.com.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mafuta
authors.affiliation: Kinshasa School of Public Health, School Public Health, Faculty of Medicine, University of Kinshasa, Po Box 11850, Kinshasa 1, DR, Congo. paulinmutombo2004@yahoo.fr.
authors.forename: Paulin B
authors.initials: PB
authors.lastname: Mutombo
authors.affiliation: Diabetes Education Center, Kinshasa, Democratic Republic of Congo. dimbelolo@yahoo.fr.
authors.forename: Jean Claude M
authors.initials: JC
authors.lastname: Dimbelolo
authors.affiliation: Department of Internal Medicine, University Clinics of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo. belly.bieleli@gmail.com.
authors.forename: Isidore E
authors.initials: IE
authors.lastname: Bieleli
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D015023:Democratic Republic of the Congo; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D012307:Risk Factors