Health system capacity to respond to flood-related health challenges: A case study of Kinshasa, Democratic Republic of Congo, August 2025
1
Africa Epidemic Service, Africa CDC, Addis Abeba, Ethiopia
2
Disease Control, National Public Health Institute, Kinshasa, Congo, Democratic Republic of the
3
DG, National Public Health Institute, Kinshasa, Congo, Democratic Republic of the
4
Public Health Emergency Center, National Public Health Institute, Kinshasa, Congo, Democratic Republic of the
5
Health information department, Health Division Provincial, Kinshasa, Congo, Democratic Republic of the
Popul. Med. 2026;8(Supplement Supplement 1):A424
ABSTRACT
INTRODUCTION:
Kinshasa, the capital of the Democratic Republic of Congo, is highly vulnerable to climate change-related disasters, particularly flooding, due to its location along the Congo River and its extensive hydrographic network. Recurrent floods disrupt healthcare delivery, weaken community resilience and pose significant public health threats. This study assessed the capacity of the kinshasa Health system to respond to flood-related health impacts.
METHODS:
A cross-sectional mixed methods study was conducted at the operational levels of the health system. Twenty-seven health facilities were selected through a multistage sampling approach to ensure representativeness across urban and rural settings. Data were collected using structured questionnaires, complemented by interviews and focus groups. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent thematic content analysis, both mapped to WHO’s six health system pillars.
RESULTS:
Flooding was reported in 92% of health areas and 37% of facilities. No flood-specific response plan existed at the health zone or facilitiy levels, although 51% of facilities had crisis management committees. Service delivery was limited, particularly in surgical care (55%) and mental health services (11%). The early warning surveillance system was operational, but flood-related data was transmitted in a non-standardized manner. Most facilities remained operational despite limited disaster-related training, yet 62% lacked first aid kits, and 77% had no internal emergency funding. Cholera outbreaks were reported by 37% of facilities after floods. Qualitative findings showed that despite community-led mitigation efforts such as temporary dikes and drainage clearing, exposure to contaminated water remained high, leading to widespread urogenital infection. In addition, financial barriers limited access to health care, particulary among vulnerable groups.
CONCLUSIONS:
Substantial preparedness and response gaps exist within Kinshasa’s health system. Strengthening resilience requires developing contingency plans, digitalizing surveillance and flood related reporting, enhancing workforce training, and the establishment of sustainable emergency financing mechanisms.
Kinshasa, the capital of the Democratic Republic of Congo, is highly vulnerable to climate change-related disasters, particularly flooding, due to its location along the Congo River and its extensive hydrographic network. Recurrent floods disrupt healthcare delivery, weaken community resilience and pose significant public health threats. This study assessed the capacity of the kinshasa Health system to respond to flood-related health impacts.
METHODS:
A cross-sectional mixed methods study was conducted at the operational levels of the health system. Twenty-seven health facilities were selected through a multistage sampling approach to ensure representativeness across urban and rural settings. Data were collected using structured questionnaires, complemented by interviews and focus groups. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent thematic content analysis, both mapped to WHO’s six health system pillars.
RESULTS:
Flooding was reported in 92% of health areas and 37% of facilities. No flood-specific response plan existed at the health zone or facilitiy levels, although 51% of facilities had crisis management committees. Service delivery was limited, particularly in surgical care (55%) and mental health services (11%). The early warning surveillance system was operational, but flood-related data was transmitted in a non-standardized manner. Most facilities remained operational despite limited disaster-related training, yet 62% lacked first aid kits, and 77% had no internal emergency funding. Cholera outbreaks were reported by 37% of facilities after floods. Qualitative findings showed that despite community-led mitigation efforts such as temporary dikes and drainage clearing, exposure to contaminated water remained high, leading to widespread urogenital infection. In addition, financial barriers limited access to health care, particulary among vulnerable groups.
CONCLUSIONS:
Substantial preparedness and response gaps exist within Kinshasa’s health system. Strengthening resilience requires developing contingency plans, digitalizing surveillance and flood related reporting, enhancing workforce training, and the establishment of sustainable emergency financing mechanisms.
| eISSN: | 2654-1459 |
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