Barrières et facilitateurs dans la mise en œuvre en première ligne d’un modèle biopsychosocial de soins au Sud-Kivu en République Démocratique du Congo
(2025)
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- Abstract
- The thesis examines implementing a biopsychosocial (BPS) model in healthcare centers in the South Kivu region of the Democratic Republic of Congo (DRC). The introduction highlights the growing importance of adapting Primary Health Care (PHC) to a holistic approach to healthcare, particularly in low-income countries such as the DRC. The main objective is to investigate the feasibility of organizing healthcare services based on a BPS model to provide person-centered care at the primary level. The overall methodology employs a descriptive and evaluative qualitative approach, utilizing specific theoretical tools and analysis methods for each study. The first study focuses on the barriers and facilitators to implementing BPS care at healthcare centers. It reveals challenges such as healthcare workers' lack of understanding of BPS care and positive aspects such as the availability of care teams. The second study analyzes the organizational capacity of healthcare centers to implement a BPS model, highlighting strengths in basic structures but also weaknesses in organizational governance and person-centered culture. The third study explores individual changes and healthcare workers' practices in adopting a BPS model, showing a positive but variable acceptance of this model by a minority of workers. Training and team meetings are identified as essential for promoting BPS care skills. Lastly, the fourth study examines the implementation of the BPS model in six healthcare centers, revealing a transition towards more holistic care practices, particularly in patient record management, case discussions, and home visits. The general discussion summarizes the results of the four studies, highlighting the challenges and opportunities of implementing a BPS model in healthcare centers. It emphasizes the importance of organizational and individual support, continuous monitoring, stakeholder collaboration, and adaptation to the local context to ensure successful and sustainable implementation. The conclusion underscores the promising results of providing care through a BPS model while recognizing persistent challenges such as resistance to change and the need for staff training. By overcoming these challenges, healthcare system stakeholders can contribute to the success of implementing and providing care based on the BPS model, offering significant potential to improve the quality of care and patient experience, particularly in diverse healthcare contexts like that of the DRC.
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Citations
Molima Eboma Ndjangulu, C. (2025). Barrières et facilitateurs dans la mise en œuvre en première ligne d’un modèle biopsychosocial de soins au Sud-Kivu en République Démocratique du Congo. https://hdl.handle.net/2078.5/243000