At the request of the National AIDS Control Program (CNLS), two IntraHealth International specialists recently assessed the Republic of Congo’s human resources for health and the quality of health care in an initial step to improving Congo’s health care system, which has been overwhelmed by years of conflict and inadequate financial investment. The country’s public and private health facilities have suffered from chronic shortages of health care workers (especially in rural areas); lack of essential drugs, supplies and equipment; shortages of water and electricity; and insufficient management from upper-level health authorities. Too few health care workers are trained in the skills needed to address the population’s health needs, such as HIV prevention and treatment, malaria control and skilled attendance at birth. The population, especially women and children, are extremely vulnerable to illness and death, and the Republic of Congo has very high infant and maternal mortality rates.

The Republic of Congo has prepared its Second National Health Plan (2007-2011) with a goal of improving the health of the general population, particularly women and children, and reinforcing the health system. As part of its national health and HIV/AIDS program, the Government of Congo has adopted a policy to cover treatment for HIV/AIDS, tuberculosis and malaria (for mothers and children) from the central budget. As a first step towards this policy’s implementation, the Ministry of Health, the National AIDS Commission (NAC) and the CNLS requested that a team of IntraHealth specialists conduct a rapid assessment of the health care human resources situation in the Congo and the quality of care of selected health facilities in providing the essential package of services.

Supported by the Ministry of Health and the NAC/CNLS, Boniface Sebikali and Lauren Crigler partnered with a local team to conduct an assessment of twenty health care facilities within and around Brazzaville, Pointe Noire and Dolisie. Results indicated several weaknesses in the Congolese health system that must be addressed and that undermine efforts to address the resulting gaps found in production (such as the inadequate preparation and training of providers), in recruitment (new hires are poorly matched for positions), in deployment (severe shortages exist in rural areas and surpluses in urban areas) and retention of personnel (new hires leave within months or desert immediately).

The facility assessment highlights the need to:

• Improve in-service provider training and provider support (through supervision, job aides and providing adequate supplies)
• Increase incentives to providers, especially those working in rural areas
• Improve facility administration and management
• Increase community involvement in health services.

Although the human resources situation in Congo is dire, there are positive things to build on, such as the Republic’s president recently announcing a program to alleviate some of the imbalance in salaries and incentives for health workers, and the Ministry of Health having developed a human resources for health plan that addresses many of the gaps identified in this assessment.

Photos do not indicate health status of the people photographed.