The centralized nature of care led to overcrowding and long wait times became common, while access was difficult for some patients travel time. To address this problem, the project began to support the decentralization of services to other health facilities in An evaluation of the decentralization component was already carried out in and finalized in that focused on the evolution of the decentralization strategy from to , as well as the results achieved.
In , MSF commissioned a second evaluation of the decentralization component of the project, covering the period to It was conducted by a group of external evaluators. The scope of the evaluation focused on 1 the relevance and coherence of decentralization objectives; 2 coherence between the objective of decentralization, the strategy deployed and the implementation on the ground; and 3 identification of lessons learned in relation to decentralization in general and the types of organization of the decentralization intervention in the city of Kinshasa integrated and non-integrated.
The evaluators recommend MSF to 1 extend support for decentralization to other health facilities in non-integrated areas, 2 strengthen support for health structures through long-term technical support, 3 improve project data and information management, 4 improve the preparation of MSF's disengagement and to 5 advocate for the inclusion of quality improvement aspects in the process to decentralize HIV care in the DRC.
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