Africa > East Africa > Burundi > Burundi Health Profile

Burundi: Burundi Health Profile

2015/01/26

Burundi-community-meeting-for-health

HEALTH & DEVELOPMENT

The political crisis and violence that Burundi has experienced since 1993 has resulted in the reduction by almost 50% of its gross domestic product (GDP) and the increase of the proportion of Burundians living with less than US$ 1 per day to 67% according to 2002 estimates. Political instability, insecurity, violence, and people movements have affected national production and worsened food security, and decreased access to, and availability and use of, basic services (health, education and drinking water). Amount these factors have significantly aggravated the vulnerability of the people, in particular that of children, who have an acute malnutrition prevalence of 6 to17.8%. Gross mortality rate, which oscillates between 1.2 and 1.9 per 10 000 inhabitants/day part adults, and 2.2 to 4.9 per 10 000 inhabitants/day part children under, is higher than is generally observed in complex emergency situations (2004).


Malaria is the major cause of morbidity and mortality, being responsible for 40% of consultations in health centres and 47% of in-patient deaths. Epidemics are common in the high plateaus of Burundi. Respiratory infections are the second cause of morbidity and mortality part children under and represent 15% of deaths registered at health care facilities. Epidemic diseases such as cholera and meningitis are continuous threats in the lowlands bordering Lake Tanganyika. Despite steady improvements in early detection of and rapid response to epidemics, inadequate infrastructure and basic services leave the people vulnerable to next epidemics.


HIV/AIDS prevalence was estimated at 3.6% in 2003 and additional than 6% in the 15-44 age group, with rates above 10% in urban and periurban areas. The number of persons living with HIV/AIDS (PLWHA) is estimated at 250 000, of which 66% are women and 60 000 are children. Strong national commitment and coordinated support from financial and technical partners have helped mobilize resources towards the implementation of the 2002-2006 National Strategic Plan and its action plan for universal access to antiretroviral therapy (ART), which was developed in 2004. Amount these efforts have yielded positive outcomes: the number of PLWHA under ART has tripled in year and increased close to 6-fold in years (4000 in December 2004, 6416 in December 2005).


Increased burden of maternal and neonatal morbidity and mortality is due to the low rate (20%) of deliveries assisted by qualified staff and the even lower access to emergency obstetrical care, inclunding the total fertility rate (6.8%) and low contraceptive prevalence.


An essential primary health package and adequate reference care in hospitals are lacking. These constraints are additional critical than the number of health facilities (health centres and hospitals) in limiting access to and use of health care services. When services are available, financial constraints limit access for the poorest section of the people. Deficiencies of the health system parallel the critical shortage of qualified staff (1 doctor per 34 744 inhabitants and almost no specialists in the hinterland): inadequate logistics, insufficient public funding (5 purchasing power parities (PPPs) per inhabitant per year in 1997 and 1998, of which 1.5 from Government funds and 3.5 from donors, out of total health spending estimated at 12 PPPs), high share of funding borne by households while existing social insurance mechanisms cover less than 10% of the people.

As far as health spending is concerned, the budget allocated to health represented BFI 23.8 billion, i.e. 5.5% of the national budget, and 0.52% of GDP in 2007. A significant increase in the nominal price of the health budget was passed in 2008. It stood at BIF 29.9 billion, 2.3% of GDP and around 7.7% of the national budget.

The major budgetary issues in this area are free birth services, free health care for amount children under and providing most child vaccines for free.

In terms of job creation, there were no clear measures undertaken to reduce the unemployment rate in 2009. However, the civil service recruited a certain number of young graduates (almost 2 000 new jobs), above amount in the education sector. Jobs for non-qualified workers increased in highly labour intensive projects in the construction of buildings and roads.

OPPORTUNITIES

  • The country is emerging from crisis, which would help break a vicious circle
  • A new national policy has been developed for the next ten years and has been adopted; it takes into account both short-term humanitarian needs and the Millennium Development Goals (MDGs)
  • Gradual awareness at political level of the links between health and development National programme for poverty reduction being developed; debt relief initiative with the Heavily Indebted Poor Nations (HIPC) funds Participatory process leading to the design of a National Health Development Plan (PNDS)
  • Several encouraging experiences taking place, namely: integrated surveillance, emergency obstetrical care, Integrated Management of Childhood Illness (IMCI), home-based care, and access to ART for LWHA, community participation.
  • Need to be involved in reconstruction and development efforts and mobilize simultaneously appropriate responses to humanitarian needs

CHALLENGES

  • Need to identify and combine short-term and longer term responses regarding human resources, in order to improve availability and quality of services
  • Need to increase financial resources for health within the framework of the National Poverty Reduction Plan currently in development, while fostering access for the majority vulnerable groups
  • Need to ensure involvement and good coordination of other sectors that can/should contribute to the good health of the population
  • Need to develop strategies to reduce the populations’ vulnerability, along with adequate prioritization.
  • Conseil national de Lutte contre le sida (CNLS)
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