Improving access and quality of primary healthcare through women and
adolescents’ user committees: a mixed-methods case study in Kinshasa,
DRC
Abstract
Background. Patient engagement is seen as a fundamental
strategy for achieving quality patient-centred care, especially in
community-based primary healthcare (OMS2023, Haesebaert et al. 2018).
Despite growing interest in patient engagement in Sub-Saharan Africa,
few patient engagement initiatives have been identified, and those often
are limited to lower-levels of engagement, in participation in health
research or in health system improvement (Gogovor et al. 2023). With the
aim of giving a voice to under-represented community groups in
healthcare governance, the ASSK project supported the implementation of
primary health services user committees in the Democratic Republic of
the Congo (DRC), designed to enable the representation of two user
groups with specific unmet sexual and reproductive health (SRH) needs:
women and adolescents. Aims and Methods. Using a mixed-method
case study design combining quantitative secondary data (DHIS2) and
qualitative data from two research World Cafés (WC1:Women user
committees (WUC) n=55; WC2: Adolescents user committee (AUC)
n=63)(Schield et al. 2022), this paper looks at the implementation
facilitators and barriers, and at the results of this initiative.
Results. Women and adolescent members of the user committees
highlighted that their participation resulted in increased knowledge of
SRH and their related rights, as well as in their “soft skills” such
as communication and leadership. In addition, participants reported
greater transparency and accountability on the part of the community
primary health centers (e.g. by displaying fees for procedures to
counter over-billing). Ultimately, WUC and AUC were associated with
improved health practices in the community such as increased use of
sexual and reproductive health services, including adolescent family
planning and assisted childbirth (15-49 years old).
Conclusions. Patient user committees for specific marginalized
or under-represented groups appear to be an effective way of improving
the quality of primary health care services. Further research is needed
to better understand how to maximize its potential.