Analyse des coûts directs des soins de santé chez les enfants de moins de 5 ans dans les hôpitaux de Lemera, Walungu et Ibanda au Sud - Kivu, en République Démocratique du Congo

Introduction: Financial inaccessibility to health services is aggravated in some health zones by armed conflicts. This study analyzes the direct costs of care for children under 5 years old based on the Integrated Management of Childhood Illness approach (PCIME). It compares the direct costs of care with the solvency of the care bill issued according to the pricing applied in hospitals in three health zones (Ibanda, Walungu and Lemera) in South Kivu, in the Democratic Republic of Congo. This province has been experiencing recurrent armed conflicts for thirty years. Methodology: The study is comparative cross-sectional, conducted from January to December 2018 in hospitals and health centers in the health zones of Ibanda, Walungu and Lemera in South Kivu. Data collection mainly relied on documentary review (patient files, hospital registers, laboratory registers, cash books and issued invoices). Data analysis was performed using Excel 2016 and SPPS software. The frequencies, the proportions and the median were identified. The comparison of the proportions was carried out. A logistic regression model testing the associations was applied and one-way analyzes of variance or Pearson's correlation test were performed for the observed variations. Results: The direct cost of health care for children under 5 years old remains high, although the cost of care for the majority of pathologies is less than or equal to $US50 (p