Trends in socio-economic level and accessibility to healthcare of households in Eastern Democratic Republic of Congo from 2011 to 2023: Documentary review of South Kivu

Background In the Democratic Republic of Congo (DRC), the population's standard of living has deteriorated over the years as a result of the country's worsening socio-economic, security and political context. The aim of this study was to assess changes in the socio-economic level and accessibility to healthcare in health zones of South Kivu province between 2011 and 2023. Methods A literature review was carried out on changes in the socio-economic level of households in the province of South Kivu and access to healthcare from 2011 to 2023. The search was carried out in the PubMed and Google Scholar databases and on non-governmental organizations (NGO) websites, using keywords relating to socio-economic level and access to healthcare in South Kivu and the DRC. Results A total of 11 documents were selected out of 74 consulted for thematic analysis. Data from South Kivu show various changes in households. The proportion of female heads of household increased from 14% in 2011 to 43.8% in 2023. Illiteracy among household heads fell slightly, reaching 23% in 2023. Mean household size increased from 6.8 to 10 persons. Mean monthly income fell from USD 190 to 67 between 2013–2014 and 2023. The number of episodes of illness per household also increased, from 1.1 in 2011 to 2.3 in 2023. Despite a majority of households living less than 30 minutes from a healthcare facility, self-medication and sale of assets to cover healthcare costs became more common. Conclusion The socio-economic situation in South Kivu is deteriorating, with falling income and the majority of the population living below poverty line, impacting access to health services in spite of favourable regional access. The number of female heads of household likely increased partly as a result of armed conflicts conducing to death or physical disability of spouses. In terms of water, hygiene and sanitation (WASH), improved access to drinking water was offset by unhygienic latrines and food security challenges. Targeted action is needed to improve access to basic services and promote sustainable development with a view to achieving universal health coverage in the DRC.