title: [Reorganization of the provincial health system in the Democratic Republic of the Congo].
abstract: BACKGROUND
  In the framework of implementation of health system reform in the Democratic Republic of the Congo (DRC), and in a context of decentralization dictated by the National Constitution, this study presents the process and results obtained in terms of the provincial level of health care organization in DRC.
  
  
  METHODS
  A two-year multidisciplinary interventional research protocol was elaborated with two phases and 9 steps including organizational analysis, team building, and organizational learning. It resulted in transformational actions and improved knowledge, allowing the development of an innovative organizational model of the intermediate level of the health care system in the Democratic Republic of the Congo.
  
  
  RESULTS
  This interventional research gave rise to function plans set up by the provincial health division (PHD) in order to develop a more participative management and to compensate for the weaknesses of the current structural organization. Experts provided support to PHD for implementation of a new structure in order to institutionalize this new participative management. The new organizational structure of the PHD is based on 4 professions: i) health district support; ii) control and inspection; iii) information, communication and research and iv) resources management. PHD and experts defined these professions and described the required skills. RESULTS were integrated into the new national health plan.
  
  
  CONCLUSIONS
  Apart from the concrete results obtained, two major challenges need to be addressed: i) support the transformation of PHD from the current situation to the new model and ii) extend this new model to the other provinces, according to the same participative approach, a necessary condition to adjust the organization flow-chart to the context.
authors: Jean Bosco Kahindo
authors: JB
authors: Mbeva
authors: Carole
authors: C
authors: Schirvel
authors: Eliane
authors: E
authors: Godelet
authors: Alain
authors: A
authors: Wodon
authors: Denis
authors: D
authors: Porignon
authors: Michel
authors: M
authors: Bonami
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D015023:Democratic Republic of the Congo; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D017146:Models, Organizational