Abstract
Background
WHO recognizes that achieving Universal Health Coverage as well as the Sustainable Development Goal related to health will succeed if a particular focus is placed on Primary Health Care, its different strategies including community engagement, and this by promoting the Person-Centered Care approach. Community engagement in the Biopsychosocial model of care is little explored. The aim of this study is to describe community involvement and engagement in decision-making and implementation of interventions around the biopsychosocial model of integrated health care at the health center level.
Methods
This qualitative research was conducted at the three levels of the Democratic Republic of Congo health system (national, provincial and peripheral in 3 Health Districts in South Kivu). We conducted 4 Focus Groups with Community Health Workers and 35 individual interviews with participants selected by convenience, including 12 members of the Health Areas Development Committees involved in the study and 23 health professionals at three levels of the health system, during the period from February to April 2024. A content analysis of the discourse from the various interviews was carried out.
Results
Community engagement around the biopsychosocial model of care is influenced by a variety of contextual factors, including active interaction between patient families, support bodies (patient clubs) and other local governance structures (Health Area Development Committees, Community Animation Units); social dynamics (participatory and collective planning of health activities, provider-community discussion spaces, community-based patient monitoring on prevention, care and promotion, service assessments); and available resources (community support funds).
Conclusions
Taking into account the financial and non-financial incentive factors mentioned in our study to facilitate the motivation and satisfaction of Community Health Workers, a broad awareness and dissemination of information on the biopsychosocial model at all levels of the health system, the activities of financial self-sufficiency also mentioned, accompanied by the framework measures, will contribute to a sustainable community engagement as well as the improvement of the quality of care and the use of health services.