The Democratic Republic of the Congo has a total population of over 78 million (2016). The country has 0.075 doctors and 0.55 nurses per 1,000 inhabitants, , . The World Health Organization estimates that less than 2.3 health workers (doctors, nurses and midwives only) per 1,000 would be insufficient to meet primary care needs.  
The DRC's health system is inspired by the 1978 Declaration of Alma Ata, based on the "Primary Health Care" strategy, and the 1987 Bamako Initiative, which enshrined the participation of populations in the management of the health system with cost sharing, , . Health care has undergone reforms in 2004, 2006 and 2008, maintaining the principle of population cost-sharing. This makes health care inaccessible to many, if we consider the costs of medical services and the level of poverty of the population: family incomes of less than USD 50 per month, and a population scattered over a large territory without adequate means of transportation and the absence of health workers.
The government has included all government, private and NGO hospitals in the national health system.
To alleviate health needs, the Centre Hospitalier Mère-Enfant Monkole was founded in 1991, promoted by a non-profit organization: the Centre Congolais de Culture, de Formation et de Développement (CECFOR).
Located in the municipality of Mont-Ngafula about 20 kilometers from the center of Kinshasa, it has a direct area of influence on a population of about 500,000 inhabitants. In a social environment of poverty, the Mère-Enfant Hospital in Monkole offers medical and humane care to patients in the area and to anyone who expresses a desire for assistance. A large number of its patients are from the Kinshasa area and many of them (54%) come through hospital agreements with private companies that pay for their medical care. This makes it possible to subsidize the care of patients in the most vulnerable categories.
The hospital seeks to offer quality care through programs and projects with public and private partners.  Thanks to the quality and variety of services, in 2001 it was named General Reference Hospital of the Health Zone of Mont-Ngafula by the Ministry of Health in an informal way and in 2011 in a definitive way. Since then, the Mère-Enfant Monkole Hospital Centre has been collaborating with the Ministry of Health and the health structures of the Democratic Republic of the Congo in the development of the health sector.  
Primary care in the DRC is mainly carried out by nurses, who do preventive medicine, follow-up of healthy and sick children, prenatal evaluation and follow-up, and delivery care.
Accompanying the activities of the Centre Hospitalier Mère-Enfant Monkole, committed to improving primary care in the Congo, the Centre Congolais de Culture, de Formation et de Développement (CECFOR) promoted the Institut Supérieur en Sciences Infirmières (ISSI) in 1996.  The school transmits a real awareness of the role and responsibility of nursing personnel in the Congolese community. The students learn to carry out their work professionally and - beyond the objective of earning a salary - with the awareness of providing direct service to patients, doctors, families, etc.
The work system is based on regular mentoring to accompany each student through all the steps of her training. The ISSI, has prestige throughout the country where 30 to 35 sick people graduate per year. The training in the Monkole environment guarantees a learning of techniques, work methodology and hospital hygiene that provides a comprehensive training, being then highly demanded for jobs in the hospitals of the region.
In addition to the nursing degree, the ISSI offers a master's degree in health programme administration "Master Administration des Programmes de Santé (MAPS)".
The project seeks to strengthen the public system by training health personnel in the most vulnerable areas such as pediatrics, obstetrics and gynecology, and emergency medicine.