The health sector in the DRC is engaged in reforming the management of the health system in accordance with the principles of inclusive and participatory governance in a spirit of mutual responsibility and accountability. This article focuses on an assessment of the functioning of the health system management system in the province of Equateur in the Democratic Republic of the Congo, based on observations, with a descriptive and analytical approach. The descriptive approach made it possible to identify the contours of the system's management in the vision of improved governance of the health system. The analytical approach allows us to focus on the origin and participation of the stakeholders in the work, the subjects dealt with, and the relevance and implementation of decisions. The dialogue between technicians and politicians has been analyzed.The steering structures exist and different stakeholders take part in them with enthusiasm and lead to appropriate decisions and recommendations. However, the implementation of decisions and recommendations is not yet optimal due to the lack of a mechanism for dialogue between technicians and politicians.