Violence against health care workers in a post-conflict context: an exploratory qualitative study in the province of South Kivu, Eastern Democratic Republic of Congo

06/07/2026

AI Summary

Healthcare workers face physical, verbal, psychological and economic violence from patients, companions, colleagues, and authorities.
Causes include interpersonal staff-patient tensions, cultural norms and systemic organisational failures leading to adverse effects on worker wellbeing and care quality.
Prevention requires integrated reforms on accountability, governance and working conditions, plus active political engagement to develop and implement effective prevention strategies.

AI Summary

BACKGROUND: Violence against healthcare is a significant public health issue worldwide, yet it remains poorly documented in resource-limited countries, especially in sub-Saharan Africa.

This study aims to explore the causes of such violence, types, perpetrators, consequences and mechanisms for its prevention within the post-conflict context of the South Kivu province in eastern Democratic Republic of the Congo (DRC).

Integrated health system reforms addressing accountability, governance, and working conditions are needed to prevent violence against healthcare workers, with engagement of political authorities essential for developing and implementing effective prevention strategies.

Basic summary

Confl Health. 2026 Jul 5. doi: 10.1186/s13031-026-00821-1. Online ahead of print.

ABSTRACT

BACKGROUND: Violence against healthcare is a significant public health issue worldwide, yet it remains poorly documented in resource-limited countries, especially in sub-Saharan Africa. This study aims to explore the causes of such violence, types, perpetrators, consequences and mechanisms for its prevention within the post-conflict context of the South Kivu province in eastern Democratic Republic of the Congo (DRC).

METHODS: This exploratory qualitative study was conducted from April to May 2022 in the health zones (HZ) of Kamituga, Katana and Walungu. A diverse group of participants, including health system stakeholders, community members and policy makers were interviewed, through Focus Group Discussion (FGD) and key informant interviews (KII), guided by a pre-established interview guide. A deductive thematic analysis was carried out and the verbatim quotes were used to illustrate the respondents’ comments.

RESULTS: A total of 143 participants were interviewed for this study. The types of violence reported included physical, verbal and psychological abuse, threats through communication channels and economic abuse (misappropriation of funds, unpaid discharge). The identified causes included interpersonal dynamics within the healthcare staff and between staff and patients, cultural influences and systemic organisational issues. Aggressors varied, spanning from patients and their companions, to the healthcare workers themselves, alongside political, administrative and customary authorities. The violence has far-reaching negative consequences, affecting the individual health care workers, their colleagues and the overall quality of healthcare delivery. Pre-existing warning and prevention mechanisms include recourse to the hierarchy, silence, the utilization of suggestion boxes, regular meetings at the Central Zone Office and supervisory measures.

CONCLUSIONS: Violence against healthcare professionals is a well-known but poorly documented issue that affects both their wellbeing and professional performance. Integrated health system reforms addressing accountability, governance, and working conditions are needed to prevent violence against healthcare workers, with engagement of political authorities essential for developing and implementing effective prevention strategies.

PMID:42402617 | DOI:10.1186/s13031-026-00821-1

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