Journal of Geoscience and Eco Agricultural Studies

Abstract

In the Democratic Republic of the Congo, the predominance of out-of-pocket household payments, weak financial protection mechanisms, and inadequacies in healthcare supply limit access to health services. In the Beni Health Zone, these constraints are further aggravated by structural poverty and security instability. This study aimed to assess the economic situation and the level of accessibility of healthcare services in the Beni Health Zone.

A cross-sectional analytical study with a quantitative approach, integrating an economic evaluation, was conducted among 398 households selected through stratified probabilistic sampling. Data were collected using a structured questionnaire and document review, and analyzed using SPSS version 20. Descriptive statistics and logistic regression analyses were performed to identify factors associated with non-utilization of healthcare services and self-medication.

The findings revealed that 71.8% of households had monthly incomes below USD 200, with a substantial share of income allocated to healthcare expenditures. The main coping strategies included borrowing, selling assets, and reducing food expenses. Healthcare supply was characterized by low health insurance coverage, shortages of healthcare personnel, and frequent stock-outs of essential medicines. Financial constraints were significantly associated with non-utilization of healthcare services (OR = 0.281; p < 0.001), while self-medication was strongly associated with high healthcare costs and family practices.

The study highlights limited financial accessibility and a high economic burden of healthcare in the Beni Health Zone. Strengthening financial protection mechanisms, improving healthcare supply, and regulating self-medication are essential to enhance equity and efficiency within the local health system.