Accessing health services in the Democratic Republic of Congo: Perspectives of the elderly

1. Accessing health services in the Democratic Republic of Congo: Perspectives of the elderly Ganzamungu Zihindula Pranitha Maharaj Maharajp7@ukzn.ac.za

2. Background • The Democratic Republic of the Congo (DRC) is situated in central Africa and is the third largest country in Africa. • The country is vast and rich in natural resources but the majority of the population lives in poverty. • Poverty is a major problem in the country with 71.3% of the Congolese surviving below the income poverty line (UNDP 2010). • Hunger is a major problem for a large sector of the population. • The life expectancy remains low at 48 years but there are a substantial number of older people in the country given the massive population (UNDP 2010).

3. Background • For the past several decades the DRC has been characterized by severe conflict and political upheavals. • This has had serious implications for the health sector, and also has negatively impacted on the health of thousands of civilians. • The health of older population in the country has also suffered as a result of decades of armed conflict.

4. Background • Given the situation in the country it is difficult to come across reliable data on the health situation of the population, particularly the older sector.

5. Aim of the study • The aim of the study is to shed some insights into the health and health seeking behaviour of the elderly.

6. Methodology • The study relies on qualitative data that comes from in-depth interviews. • 20 in-depth interviews

7. Perception of Health • Almost all the respondents reported poor health, stating that they suffered from a range of health ailments. • Men and women associate old age with poor health and they expect to experience ill-health. • Some argue that poverty was exacerbating their health situation.

8. Health Seeking Behaviour • Interviews revealed the desperate situation of men and women who are suffering from ill-health in the DRC. • Their precarious financial situation places them at a great disadvantage. • In most cases, access to treatment in the DRC is limited by financial barriers. • Without money they will not receive health services.

9. Health Seeking Behaviour • Accessing health facilities in the rural areas is a huge challenge. • The long distance to the health centre is a major barrier to utilization of health care services. • Many of the rural areas in particular do not have proper roads and it is difficult to get around these areas. • In addition, the trip to the health facility is long and exhausting for them, especially for the sick and frail. • Some fear visiting health facilities because of the fear of physical and sexual violence. • It was not uncommon for women who were on their way to markets, churches and hospitals to be become victims of rape.

10. Health Seeking Behaviour • The lack of government support was perceived as a major barrier to accessing health care. • They were not aware of any social grants for the elderly.

11. Conclusion • Health services are out of reach for many of the elderly. • There is limited coverage of health services in the DRC. • In the DRC the rural areas have been most severely affected by war. • The war destroyed roads and bridges that ensured easy access to health centers. • An important issue to emerge is how the economic situation of the elderly impacted on their health seeking behaviour. • Cost is a major barrier to health care utilization. • In addition, because of their frailty they cannot access health care services without the support of family and friends.