Scope of Preventative Health Services Offered by Private Health Care Businesses in Mbujimayi in the Democratic Republic of the Congo

The creation and operation of private health care businesses (PHCBs) has been increasingly recognized and encouraged. This is particularly valid in many African health care systems that have proved incapable of adequately meeting the health care needs of their populations. However, little is known on the patterns of variation of these PHCBs in terms of professional background of owners, timing of creation and scope of preventative services offered (SPSO). Moreover, the association among these variables has not yet been explored. This study seeks to address these questions, using data from a survey of PHCBs in July 2010 in Mbuji Mayi (Democratic Republic of the Congo) such as owners’ professional background, timing of creation of PHCBs and involvement in health education, immunization, prenatal care, well-baby monitoring, home health care and obstetrical care. Scores of involvement (yes=1 or no=0) were summed up to yield a SPSO score for each PHCB. This six-item scale was evaluated in terms of internal consistency (Cronbach alpha =.86). Sixty-eight PHCBs were surveyed. Fifty-six PHCBs (82.4%) were formed by sole proprietors. Four PHCBs were created before 1990, 18 between 1990 and 2000, and 34 between 2000 and 2010. About 40% were created by nurses, 17.6% by doctors and 39.7% by all the other entrepreneurs. We found a progressive growth of PHCBs, a general decline in SPSO over time and a significant variation across professions, with physicians having higher SPSO scores than nurses and other entrepreneurs. Owners’ professional background and timing of creation explain 25 percent of the variance of SPSO (R Squared = .430 and Adjusted R Squared = .248).  There is a need to explore and address the determinant of decline in SPSO by newly created PHCBs and of lower standing of nurses and other health care entrepreneurs on this dimension.