Health Education in Mbandaka, Democratic Republic of the Congo: Perceptions, Practices, and Determinants of Behavioral Change Among Adults Attending Health Facilities – A Cross-Sectional Study
Abstract
Introduction
Health education is a fundamental pillar of nursing care and public health, particularly in contexts where infectious diseases and hygiene problems remain endemic. In Mbandaka, Équateur Province, Democratic Republic of the Congo, health challenges persist despite deployed educational interventions. This study analyzed perceptions and practices related to health education among adults attending health facilities in Mbandaka.
Methods
A descriptive cross-sectional study was conducted with a sample of 100 participants recruited from health facilities in Mbandaka. A structured questionnaire collected data on sociodemographic characteristics, conceptions of health education, information sources, participation in educational activities, reported behavioral changes, and perceived effective strategies. Data were analyzed using descriptive statistics and chi-square tests (significance threshold: α = 0.05).
Results
The sample was predominantly female (80.0%) with a predominance of the 46–50 age group (32.0%). Health education was primarily conceived as "information and awareness" (48.0%), while 36.0% did not know its meaning. Information sources were mainly non-medical (school, media, friends: 84.0%), with only 16.0% from health professionals. Participation in educational activities was low (16.0%), mainly through antenatal care consultations. Despite this, 84.0% reported changing their behavior through health education, but only 32.0% maintained these changes consistently. Hygiene was the main health concern (64.0%), followed by malaria, cough, and sexually transmitted infections (36.0%). A highly significant association was found between age and behavioral change (χ² = 300.000 > 31.41; df = 20; p < 0.05), as well as a marked gendered division of health roles. "Awareness and training" was endorsed as a priority strategy (84.0%), with government support requested by 68.0%.
Discussion
The predominance of the biomedical model (information) over the health promotion model (empowerment) reflects persistent traditional approaches. Low participation despite positive perception indicates an accessibility rather than acceptability problem. The gendered division of health roles corroborates local menstrual hygiene initiatives. The challenge of sustaining behavioral changes (68.0% non-constancy) is comparable to documented difficulties in community intervention sustainability.
Conclusion
This study reveals a Mbandakan paradox: high trust capital in health education (perceived usefulness: 64.0%, positive impact: 84.0%, unanimous
recommendation
100.0%), but low effective coverage (participation: 16.0%) and fragility of behavioral changes (inconsistency: 68.0%). These findings argue for a conceptual evolution toward the health promotion model, diversification of communication channels, and establishment of sustainability mechanisms.
Keywords
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How to cite
Nkya Nsomi, G. (2026). Health Education in Mbandaka, Democratic Republic of the Congo: Perceptions, Practices, and Determinants of Behavioral Change Among Adults Attending Health Facilities – A Cross-Sectional Study. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0024-health-education-in-mbandaka-democratic-republic-of-the-congo-percepti