We assessed the knowledge, preparedness, and attitude of health profession students towards COVID-19 outbreak in Sub-Saharan Africa. This cross-sectional study used convenience sampling to recruit participants from institutions under African Forum for Research and Education in Health (AFREhealth). The survey was developed in QuestionPro software covering the participants’ socio-demographic characteristics, knowledge, attitude, and preparedness towards the COVID-19 outbreak. Data were analysed and the association between variables was tested. The mean age of the 336 students was 25•75 (±7•88) years. Most (99•7%) knew the cause of COVID-19 which could be transmitted via droplets (97•3%). Several participants vowed to adhere to preventive measures (92•3%) and claimed their curriculum equipped them with skills addressing infectious disease outbreaks (63•6%). Nursing students were better prepared than other students (p=0•001). Students from West African regions were more prepared (p=0•001) and aware they could contract COVID-19 if they cared for infected persons (p=0•001). Students are knowledgeable about COVID-19, adequately prepared to handle epidemics, have a positive attitude towards infection prevention, and their training institutions and government have taken adequate measures to address the COVID-19 outbreak. AFREhealth

From 2015 to 2019, the "RIPSEC" program launched a mentorship program, transforming the Walungu health zone, in eastern crisis-affected Democratic Republic of Congo, into a “Learning and Research Zone” (LRZ). As part of the program, a local university was tasked with strengthening the LRZ manager’s leadership capacities, including efforts to troubleshoot challenges related to the proliferation of informal healthcare facilities (IHFs). IHFs are unregulated healthcare structures operating on the fringes of the law, and claiming to offer cheaper, higher-quality care to the local population. This study evaluates the impact of RIPSEC mentorship on leadership development and the performance in the Walungu LRZ, particularly concerning the utilization of integrated curative health services in competition with IHFs. We used a mixed method approach, combining retrospective analysis of some key health indicators before (2014) and during RIPSEC program (2014 vs. 2015–2019), and in-depth qualitative interviews with members of the LRZ management team. Quantitative data were presented as frequencies and proportions. Simple linear regression (p<0.05) measured the influence of IHFs on service use. The LRZ’s functionality and performance were assessed using an internal benchmarking approach, with results presented as trend curves. Deductive analysis of interviews allowed for a deeper exploration of quantitative trends. Despite efforts by the LRZ managers to regulate IHFs, these structures negatively impact the use of curative services by diverting patients away from integrated healthcare options. RIPSEC mentorship notably enhanced manager’s leadership skills, leading to more effective management. While the use of curative health services slightly increased during the program, rates remained below 50%, and gains were not sustained post-program. RIPSEC mentorship has positively impacted leadership and performance in Walungu. However, financial challenges and the persistent influence of IHFs continue to impede the sustainability of these gains. Comprehensive strategies beyond enhancing managerial leadership solely, are necessary.

Introduction Involving people in the provision of care and in decision-making about their health is one of the keys to success and to improving service delivery in the provision of quality health care. Patient involvement in the biopsychosocial model of care is poorly documented in the Democratic Republic of Congo (DRC). The aim of this study is to describe patients’ involvement in the choice of their health policy, their responsibility in holistic care and their capacity to support the biopsychosocial model. Methods This qualitative research was conducted in three health districts in the province of South Kivu, DRC. Using a tool inspired by the International Alliance of Patients’ Organizations’ Declaration of Patient-Centered Healthcare, we conducted 27 individual interviews between February and April 2024. These interviews concerned people in complex situations, attending health centers and belonging to patient clubs in six health areas covered by the study. A content analysis of the discourse from the various interviews was carried out. Results Patient involvement in the biopsychosocial model of care depended on multiple factors, including relational aspects (partnership between providers and patients, discussion of therapeutic possibilities and guidance for choice), educational aspects (advice and teaching received from caregivers, development of skills), empowerment (responsibility for care), organizational aspects (inclusive and participatory planning, access to different health services) and community aspects (role of entourage and patient clubs). Conclusions The various factors influencing patient involvement in the BPS model should be taken into account in the definition of policies and the process of integrating biopsychosocial care. Some of the strategies suggested to support the model, such as raising awareness of the humanization of care, improving the availability of resources and strengthening financial autonomy, will help to improve the quality of care and accessibility to quality health services.

The WHO recommends the Person-Centred Care approach, based on the biopsychosocial (BPS) model with community participation, to streamline the management of chronic diseases in Primary Health Care (PHC) activities and reduce their growing burden, even in Africa. The Democratic Republic of Congo's (DRC) experience of community participation in implementing the BPS model for chronic diseases has been little explored. To describe community ownership of the biopsychosocial model of chronic disease care in PHC facilities in South Kivu province, DRC. A basic interpretive qualitative study was conducted in April 2024, in three health areas of the Katana health district, among beneficiaries of chronic disease interventions. Nine in-depth interviews were conducted with care providers and community representatives, followed by two focus groups with community health workers (CHWs) and a document review. An inductive-deductive content analysis was carried out using ATLAS.ti 24 software. Based on the four main themes identified in the study, community ownership of the model depends on various factors (relational, organizational, and motivational/supportive). As perceptions, respondents recognized the model's application through partner support, meetings with community representatives and patient decision-making. Community involvement in the model was observed through participatory meetings, reinforced home visits, psycho-education, and club solidarity. Significant challenges included the lack of training for providers and CHWs, CHW's financial demotivation, poor dissemination of model, and patient poverty. Proposed strategies included a participatory stakeholder audit, capacity-building on the model, psychologist availability, and income-generating activities to motivate CHWs. Community ownership of the BPS model is a vital pillar to support effective and resilient chronic disease management, rationalizing it in PHC for better health outcomes. Healthcare systems should consider these identified factors in the policy definition and rationalization process for these diseases by establishing effective coordination mechanisms.