Patient Charter: A Tool for Community-Centred Care
In a conference room overlooking the rapids of the Congo River, the Congolese Observatory for Consumer Rights, better known by its French acronym OC2D, convened on 27 November a diverse assembly of physicians, nurses, community representatives and technical partners. Their common agenda was the in-depth discussion of the Patient Charter drafted last April by the Ministry of Health in collaboration with multilateral and civil-society actors (Ministry of Health, April 2023). The document, only a few pages long yet dense in implications, codifies both rights and responsibilities for users of public health facilities, from guaranteed confidentiality to the duty of respecting care pathways. By translating abstract constitutional protections into practical guidance posted on hospital walls, the Charter seeks to place the citizen, rather than the institution, at the centre of the care relationship.
The 2018 sectoral review had signalled troubling gaps in user information and community participation (Health Review, 2018). OC2D president René Ngouala recalled that finding and insisted the Charter is “not an ornamental text but a compass for transparency.” In doing so he echoed the government’s stated ambition to align national practice with African Union standards on patient safety, without rupturing existing administrative balances.
Strengthening Local Health Committees
The Brazzaville workshop forms part of a broader project aimed at revitalising twelve health committees attached to the capital’s sanitary districts. These structures—Comités de santé, or Cosa in the statutory lexicon—serve as the institutional hinge between neighbourhood populations and facility managers. According to OC2D’s project note, the objective is threefold: sharpen local governance, deepen citizen oversight and ultimately reduce complaints addressed to Integrated Health Centres.
Planned activities include a census of existing committees, capacity-building sessions for their elected members and the organisation of general assemblies designed to bring them into conformity with Decree 2020-553, the legal framework that sets out their remit. At a later stage, thematic workshops will target user committees within referral hospitals, entities that often wield limited influence despite their strategic location at the apex of the referral pyramid.
From Pointe-Noire to Brazzaville: Scaling the Initiative
The Patient Charter has already travelled a considerable distance in geographic terms. Awareness sessions unfolded earlier this year in Pointe-Noire, Dolisie, Djambala and Ouesso, each urban area presenting its own epidemiological profile. By reaching the national capital, the initiative enters a more complex arena where diverse health actors—from university hospitals to private clinics—coexist.
Arvyne Mbadi, in charge of sanitary actions in the M’Filou district, argues that Brazzaville’s demographic weight makes it a litmus test for the Charter’s relevance. “If users in the capital appropriate the text, the rest of the country will follow,” she observed on the sidelines of the meeting. Her optimism reflects a wider conviction that communication, rather than additional infrastructure, constitutes the quickest lever for improving patient satisfaction indicators.
Governance and Accountability under Decree 2020-553
The legal anchor of the current reform lies in Decree 2020-553, adopted three years ago to clarify the composition, election procedures and reporting duties of Cosa. Yet implementation has remained uneven, partly because many committees were unaware of the decree’s modalities. OC2D therefore insists that each newly trained member leaves with printed excerpts of the legal text, alongside the Patient Charter itself.
Experts present at the workshop linked stronger governance to financial sustainability. A transparent committee, they argued, can better negotiate performance-based grants or forge partnerships with health-insurance schemes. Conversely, opaque structures risk breeding the very mistrust that the Charter aims to dispel.
Stakeholder Perspectives and Next Steps
International partners such as the World Health Organization and the French Development Agency followed the proceedings as observers, signalling potential technical assistance without pre-empting domestic leadership. For its part, OC2D plans a public-awareness campaign through community radio and SMS platforms to ensure that the Charter does not remain confined to institutional corridors.
René Ngouala concluded the session by inviting health-centre managers to display the Charter in waiting rooms by the end of the first quarter of next year, a deadline described as “ambitious but attainable.” The pledge, delivered in a room resonant with cautious applause, encapsulates the project’s ethos: incremental yet concrete steps toward a health system that hears, informs and respects every patient.