Obstacles et Recours aux Soins de Santé Primaires à Mbandaka (République Démocratique du Congo) : Une Analyse Transversale dans les Aires de Santé de Bosomba et Mama wa Elikya

Abstract

Introduction: This study aimed to identify the socio-economic, geographic, and institutional determinants of healthcare access within the Bosomba and Mama wa Elikya health areas, located in the urban‑rural Wangata zone of Mbandaka, Équateur Province.

Methods: A descriptive and analytical cross‑sectional survey was conducted from January to December 2025 among 75 households selected through non‑probability convenience sampling. Sample size was calculated a priori (Schwartz formula) based on an expected prevalence of 50%, a margin of error of 10%, and a confidence level of 95%. Data were collected using a structured face‑to‑face questionnaire and analysed at two levels: descriptive and bivariate (Chi‑square test). The frameworks of Penchansky and Thomas (1981) and Andersen (1995) guided the interpretation.

Results: Most household heads were men (76%) without formal education (48%). Approximately 81.3% of respondents reported limited access to healthcare services, mainly due to financial constraints (76%). Self‑medication was practiced in 78.7% of cases and divinatory consultations in 53.3%. Bivariate analysis revealed statistically significant associations between difficult access and precarious occupation (p < 0.001), high number of children (p = 0.004), perceived high cost of care (p = 0.001), and dissatisfaction with quality (p < 0.001).

Unique Contribution to Theory, Practice and Policy:  Economic barriers remain the main obstacle to primary healthcare in Mbandaka, regardless of proximity or education. To improve access, it is recommended to implement free care for vulnerable groups and develop community-based health insurance schemes.