The challenges and our response
International Medical Corps has operated in Burundi since 1995, implementing both emergency and development programs, and addressing the needs of vulnerable people, including those in areas of armed conflict.
These programs include primary healthcare, 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 and nutrition, and social behaviour change communication (SBCC). Supported by headquarters-based technical and management systems, our field programming provides valuable assets that 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.
International Medical Corps has trained local healthcare professionals, community-based health workers and community leaders in effective preventative and curative primary healthcare practices. Our teams teach community health workers to provide better nutrition and health for children by addressing the root causes of malnutrition, by educating mothers and caregivers 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 international NGOs to improve health and nutrition among communities in Burundi’s northeastern Muyinga Province. We focus our work on training to strengthen the capacity of community health workers in primary healthcare, 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 long-term food security and nutrition strategy across the country.
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 1,000 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 behaviour change messages and posters promoting the benefits of IYCF.
Social Behavior Change Communications. International Medical Corps includes social behaviour 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 childcare groups led by “lead mothers” trained in best practices and positive deviance awareness to encourage the adoption of healthier practices. In a multi-year assistance program funded by USAID from 2008–2012, we supported nearly 200 lead mothers along with 1,440 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. Our data also demonstrate 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 diarrhoea. 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 the treatment of this disease is integrated within the health services, the Ministry of Health still must rely on the support of international NGOs and other partners. There are gaps in the capacity of the MoH to deliver prevention-and-treatment services and to ensure the 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 to 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 centres and community health workers from a remote area who conducted home visits to raise awareness against malaria and to ensure proper installation of nets offered as gifts in kind to vulnerable households living in the three 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 gender-based 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. More than 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 Burundi’s national GBV training module