Authors : Kayungura Tasinzanzu Godefroid; Charles Wafula; Samuel Tororei

Volume/Issue : Volume 11 - 2026, Issue 3 - March

Google Scholar : https://tinyurl.com/4tfrjvrj

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DOI : https://doi.org/10.38124/ijisrt/26mar1494

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Access to affordable and quality healthcare remains a persistent challenge in low- and middle-income countries, where high out-of-pocket expenditures expose households to financial hardship and delayed care-seeking. In contexts such as Eastern Democratic Republic of Congo, community-based financial mechanisms like Village Savings and Loan Associations (VSLAs) are increasingly recognized as potential pathways to strengthen household resilience and improve access to healthcare. This study examines the extent to which women’s participation in VSLA savings functions as a financial buffer influencing health-seeking behavior. A baseline cross-sectional comparative design was employed between November 2024 and January 2025 across three health zones (Goma, Karisimbi, and Nyiragongo). A total of 420 VSLA members were sampled, equally divided into intervention and control groups. Data were collected through structured interviews and analyzed using descriptive statistics, chi-square tests, and odds ratios to assess associations between savings participation, income levels, duration of membership, and healthcare utilization indicators. The findings indicate no significant baseline differences between groups in illness occurrence or healthcare utilization, confirming comparability. However, important trends emerge. While VSLA participation does not significantly influence the occurrence of illness, it is positively associated with healthcare-seeking behavior, particularly among members with 4–6 years of participation (OR = 1.91, p < 0.05). Higher savings levels are also associated with increased use of formal healthcare services. Despite these improvements, over 90% of respondents rely on out-of-pocket payments, with minimal uptake of health insurance. In conclusion, VSLA savings participation enhances households’ financial capacity to seek healthcare but remains insufficient to ensure financial protection. Integrating VSLAs with community-based health insurance and strengthening health system support mechanisms are essential to achieving more equitable and sustainable healthcare access.

Keywords : Village Savings and Loan Associations (VSLA); Health-Seeking Behavior; Financial Protection; Out-of-Pocket Expenditure; Community-Based Health Insurance (CBHI); Democratic Republic of Congo; Healthcare Access.

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