Cities of Democratic Republic of Congo experiencing a vertiginous demographic growth and a complex way of working which must be deciphered by means of relevant variables. They experience enormous difficulties in urban, demographic and health management. It’s interesting to understand their spatial and social complexity through the issue of healthfulness. Thus it is as revealing changes and urban dynamics that the management of health is studied in this doctoral research. The management of health is one of the major challenges in urban development in Kinshasa. It remains an issue all the more worrying as the strong demographic growth, the increase in sources of waste production, the popular indifference and management of the city regarding public health, the so-called diseases of dirty hands, the infant mortality rate still galloping and the meager budgets available to municipalities. The daily waste production by the population is the main source of pollution and proliferation of microbes, bacteria and other vermin that cause environment diseases such as malaria, typhoid fever, bacillary diarrhea etc. The population seems to be accommodating to this situation and is immersed in the culture of ready to throw. However population’s life and life expectancy are affected. Morbidity and mortality rates depend on it. Thus the state of uncleanliness in which Kinshasa has aroused in our mind some concerns which are an essential part of this work. The solution would pass through a collective awareness, an education system centered on the environment and a good government policy on the later.