TITLE:
Enrolment and Factors Influencing Health Insurance Coverage of Informal Sector Workers in South Kivu Province, D.R. Congo
AUTHORS:
Pascal Bizibu Kushombere, Cyprien Munyashongore, Juvénal Bazilashe Bâlégamiré, Jean Berckmans Muhigwa Bahananga, Perpétue Sifa Makorongo, Robert Kizungu Byamana
KEYWORDS:
Informal Sector, Workers’ Perception, Kivu, DR-Congo, Health Matters
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.14 No.2,
February
9,
2026
ABSTRACT: One of the biggest social security issues in South-Kivu province in particular, and the DRC in general, is that more than the vast majority of the Congolese population (i.e., informal sector workers and their dependents) have no access to any form of social protection, and therefore benefit neither from a state-funded social security system nor from a serious health insurance scheme. Social security coverage in the formal sector is also low, and only covers civil servants and employees of a few parasternal companies. The present study is of a cross-sectional analytical type to be carried out in the East of the DRC in the Province of South Kivu in Bukavu, where the vast majority of informal sector workers are concentrated in the town of Bukavu and its surroundings, scouring the atrocities of armed groups inside the province. This study focused on the use of health services and factors influencing health insurance coverage for informal sector workers, with the main objectives of: 1) Determine the social security take-up rate among informal sector workers. 2) Evaluate the use of health services by workers in the informal sector. 3) Identify the factors influencing membership of community social security schemes. The study showed that only 11.5% of people in South-Kivu province have health insurance, in nine health zones studied. Some people, duets lack of means, are often obliged to resort to traditional medicine, whatever the illness, and others are unable to join mutual health insurance schemes for, which leads them to give a portion of their small farms fields to access health services for those living in rural areas, and others to give up valuable object for those living in the city. The results of this study show that health insurance, which was intended to protect the health of members in their personal and professional life by guaranteeing access to care, is scarcely available in the case of South-Kivu. In South-Kivu, however, the study reveals that, in addition to the financial barrier, there is also disappointment about the poor management of the community social protection and health insurance system.