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Mutuelles have always played a central role in financing healthcare. In the Uvira health zone, the most dominant pathologies in terms of morbidity are malaria, ARI, gastroenteritis, anaemia and typhoid fever; and in terms of mortality, the most dominant pathologies in order of importance are malaria, anaemia, acute respiratory infections, typhoid fever and gastroenteritis.The use of mutual health insurance by households in the Uvira health zone was 33%, and this low level of use was significantly associated with : insufficient knowledge of the contribution paid by MUSA, lack of confidence in MUSA management teams, insufficient information on funds received by MUSA, insufficient transparency in MUSA management, the cost of health care services when people fall ill, the absence of quality personnel in certain MUSA member structures, the high cost of medicines in MUSA partner FOSA and the absence of certain cases of illness in certain families.