The challenges and our response
International Medical Corps has operated in Burundi since 1995 to implement both emergency and development programs, addressing the needs of vulnerable people, including those in areas of armed conflict.
These programs include primary health care, Integrated Management of Childhood Illnesses (IMCI), Community Management of Acute Malnutrition (CMAM), Infant and Young Children Feeding (IYCF), Sexual and Gender Based Violence (SGBV), Health/Nutrition and Social Behavior Change Communication (SBCC). Our field programming, supported by headquarters-based technical and management systems, provide valuable assets we use to build the capacities of our local partners. We also work to strengthen Burundi’s health system by supplying partners with medicines and medical equipment and by offering the Ministry of Health the technical support required to develop effective health strategies applicable nationally.
Primary Health Care: International Medical Corps has trained local health care professionals, community-based health workers and community leaders in effective preventative and curative primary health care practices. Our teams teach community health workers to provide better nutrition and health for children by addressing the root causes of malnutrition and by educating mothers and care givers about Infant and Young Child Feeding (ICYF) and focusing on water, sanitation and hygiene (WASH) and home management of common childhood illness. We have worked closely with other NGOs to support the Ministry of Health’s implementation of child growth monitoring programs and childhood illness management at more than 60 health facilities at the community level. We have implemented 12 pilot programs supporting child growth monitoring—work that inspired the ministry to initiate an additional six programs.
Nutrition and Food Security: International Medical Corps is currently engaged in a five-year food security program with other INGOs to lift health and nutrition levels among communities in Burundi’s northeastern Muyinga Province. We focus our work on training to strengthen the capacity of community health workers in primary health care, nutrition, Infant and Young Child Feeding (IYCF) and aspects of reproductive health, including the fertility awareness approach to family planning and the use of positive deviance when dealing with community health issues. Our objective is to reduce stunting by 10% in children under 5. To achieve this goal, we actively support the Ministry of Health in its implementation of IYCF and include ministry staff in training sessions for health professionals. We also support the ministry in its efforts to establish the foundations for a long-term food security and nutrition strategy across the country.
Community-Based Programs: Community-based Nutrition: Promotion of Infant and Young Child Feeding. Promoting optimal Infant and Young Child Feeding (IYCF) practices is an essential part of international Medical Corps strategies to achieve community best practices in nutrition. IYCF is also the cornerstone of our nutrition Interventions in food security programs aimed at reducing stunting during a child’s critical first 1000 days of life. In Burundi, chronic malnutrition affects more than half of all children, according to the 2017 Demography and Health Survey. We have worked with the Ministry of Health to develop national training modules. We have also developed behavior change messages and posters promoting the benefits of IYCF.
Social Behavior Change Communications. International Medical Corps includes Social Behavior Change Communications (SBCC) strategies in all its Burundi programs. These strategies include conducting barrier analyses early in the program, then using the results to improve methods for educating communities on good health and nutrition practices and to encourage the adoption of these methods. We also use home visits and child care groups led by “lead mothers” trained in best practices and positive deviance awareness to encourage adoption of healthier practices. In a multi-year assistance program funded by USAID from 2008-2012, we supported nearly 200 lead mothers along with 1440 Community Health Workers as they successfully promoted key health and nutrition practices in communities covering three provinces. The newly-adopted practices resulted in significantly more mothers breastfeeding their newborn child within one hour of birth—a step that often leads to exclusive breastfeeding. Data also demonstrates an increase in the proportion of children under 12 months of age completing the recommended immunisations, and more mothers using fluids to re-hydrate their children following episodes of diarrhea, while the number of households using an improved toilet increased more than three-fold, from 6.8% to 21.5%.
Malaria. International Medical Corps has strong experience in the prevention, control and treatment of malaria in both Africa and Asia. In 2016, our teams worldwide treated 235,830 cases of malaria in children under 5. In Burundi malaria remains a significant burden for the MoH and its services are highly dependent upon external support. Even though treatment of this disease is integrated within the health services, the Ministry of Health still must rely on support of INGOs and other partners. There are gaps in the capacity of MoH to deliver prevention and treatment services and ensure continuous flow of medicines and equipment needed to treat malaria effectively.
International Medical Corps successfully implemented a malaria program to improve access to high quality and appropriate malaria treatment and raise awareness of malaria prevention and care among those most vulnerable – pregnant women and children under 5, particularly those who are malnourished in Kayanza, Muyinga and Kirundo Provinces. The program was funded by the Jersey Oversea Aids Commission (JOAC). Project activities were successfully led by International Medical Corps staff and partners including the Ministry of Health through its national program against malaria. The program included 48 health centers and community health workers from remote area who conducted home visits to raise awareness against malaria and to ensure proper installation of nets offered as offered as gifts in kind to vulnerable households living in the 3 provinces. Health facilities received drugs and medical kits to diagnose and treat suspected malaria cases.
Gender-Based Violence--Prevention and Treatment: To strengthen the capacity of Ministry of Health service providers to clinically manage sexual violence (GBV) and provide compassionate care, International Medical Corps has conducted training in line with the ministry’s standards on medical support for victims and survivors of GBV. Over 60 nurses from three provinces benefited from training on the management of cases involving sexual violence and caring for survivors. We worked with Community Health Workers to distribute community-level messaging stressing the need to prevent any form of physical violence or harassment. International Medical Corps also provided the Ministry of Health with ﬁnancial and technical support in updating the Burundi’s national Gender-based Violence training module.