Integration of School Health Services in Kinshasa: Evaluating Structural Barriers, Cultural Factors, and Stakeholder Experiences

Abstract

Introduction

School health services are recognized as an essential strategy for improving students’ health and educational outcomes; however, little is known about how educational stakeholders and students perceive their integration within primary and secondary schools in the Democratic Republic of the Congo (DRC).

Purpose

This study explored the perceptions of educational stakeholders and the experiences of students regarding the integration of school health services in Kinshasa.

Methods 

A descriptive qualitative study was conducted across selected primary and secondary schools in Kinshasa to reflect diverse educational contexts. Ten teachers/educational staff members and 27 students participated in semi-structured individual interviews. Data were analyzed using Braun and Clarke’s inductive thematic analysis, guided by Bronfenbrenner’s social ecological framework.

Results

Teachers considered the integration of school health services essential for students’ well-being and academic success but identified major barriers, including inadequate funding, limited equipment, insufficient human resources, and the absence of a clear institutional framework. Students expressed generally positive perceptions while highlighting challenges related to service accessibility, shortages of health materials, and the need to modernize school infrastructure. Cultural beliefs influenced service utilization only in isolated situations. Both participant groups emphasized the critical role of government commitment, stronger school–family partnerships, and improved communication in ensuring effective implementation.

Conclusion

The findings underscore the need to strengthen teacher capacity, adapt school health interventions to the local sociocultural context, and establish structured collaboration among schools, families, and health professionals. An inclusive and context-sensitive approach could improve the acceptability, effectiveness, and sustainability of school health services, thereby contributing to better educational outcomes and greater health equity in the DRC.