Burundi

In 2007, Pathfinder began its partnership with the Burundian government. Our aim: to strengthen the health system, so it can better serve the country’s women, men, and young people, many of whom were internally displaced after the decade-long civil war.

Steady progress has been made. The percent of deliveries attended by a skilled health professional has increased. Trainings, medical equipment, and renovations, have reinforced the foundation for improved service delivery.

Still, challenges remain. Women who live in rural areas lack access to quality services, leading to high maternal and child mortality rates. And, across Burundi’s mountainous landscape, a sizeable population of refugees goes without health care.

So Pathfinder is working to reach them. In collaboration with our in-country partners, we are expanding access to critical services, including integrated family planning; HIV testing, care, and treatment; and nutrition.

Here, project staff lead community members in a discussion about a wide-array of health practices, Including nutrition, malaria prevention, and family planning.

Why Pathfinder Works in Burundi

Years of conflict and endemic poverty in Burundi have resulted in a fragile health system with limited reach throughout the country. In rural areas, lack of services perpetuates high maternal and child mortality rates as Burundians struggle with health challenges such as malaria and malnutrition. Aggravating these problems is the frequently poor quality of services available in facilities that are poorly equipped and understaffed. Recently, the government adopted a national, comprehensive strategy to integrate management of child illnesses with other key concerns such as poor rates of immunization, antenatal care, and assisted births. However, continued poor quality of services available in facilities that are poorly equipped and understaffed has limited the success of the strategy.

Since 2007, Pathfinder has been working with the Burundian government to improve the quality of maternal and child health services by creating demand for maternal child health services and by building the capacity of the health system to effectively deliver quality services to meet the demand. Partnering with the Ministry of Health, steady progress has been made, such as increasing the percent of deliveries attended by a skilled health professional, decreasing the number of severely underweight infants, and increasing the number of households with mosquito nets. Trainings, medical equipment, and renovations, have further reinforced the foundation for improved service delivery across a wide range of health issues.

Evidence for Decision-Making

A key aspect of Pathfinder’s approach to systems’ strengthening is collecting evidence that enables public, private and community partners to make informed health-related decisions across a range of areas in which we work. In Burundi, examples of the kinds of evidence we collect range from “Number of health facilities which obtained quality scores above 70 percent in the last quarter” and “Total number of deliveries assisted by a skilled birth attendant” to “Total number of people selected and trained to be professional trainers on sexual and gender-based violence case management.” Noteworthy improvements to Burundian healthcare to which Pathfinder has made a leading contribution include:

• 17 health facilities with all the 25 performance-based financing (PBF) monitoring indicators showed a difference of less than 5% between verified and reported data
• 926,055 long lasting insecticide-treated nets were distributed with Pathfinder's Maternal and Child Health Program support
• 58,710 children received all vaccines required within 1 year

Building Capacity, Strengthening Systems

Of particular importance for Pathfinder’s work in Burundi is service integration. Pathfinder Burundi’s overarching strategy to improve integration of health services is defined by two guiding principles:

• Support the health system decentralization efforts by ensuring that the health districts are functional and ensuring communities are involved in the management of the health system
• Support the health system’s capacity to make information quickly shareable to ensure that it is responsive to governmental, implementer, and the public’s needs

Pathfinder Burundi achieves these principles by assisting in the reform of the health sector, including improving management of human resources and supporting both the development of national policies such as the National Development Plan and the implementation of the recommendations of the Health Sector Audit. Pathfinder supports the Ministry of Health in seeing that the necessary physical infrastructure of health district offices and hospitals is in place. Quality of care is not only dependent on facilities but the people that operate them, so we also help recruit and train technical staff at the districts levels. In addition, Pathfinder builds institutional capacity by seeing to it that health facilities are regularly supervised by health district teams and that supportive supervision is encouraged through a series of trainings for managers and supervisors on “Management, Leadership and Mentoring.”