Patient involvement in the biopsychosocial model of care integrated with primary health services: Experience from three health districts in South Kivu, Democratic Republic of Congo

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.