Dr. Sabine Ntakarutimana, Minister of Public Health and the Fight Against HIV/ AIDS, discusses challenges and recent progress in Burundi’s healthcare sector.
European Times: Can you describe the organisation of Burundi’s healthcare system?
Dr. Sabine Ntakarutimana: The Ministry of Public Health and the Fight Against AIDS oversees the entire public healthcare system, which includes 63 hospitals, including four national referral hospitals in Bujumbura, and 45 healthcare districts throughout the country. We have a department in charge of resources, one in charge of planning, a branch in charge of public health and the fight against AIDS, and various autonomous institutions, including the central organisation for purchasing pharmaceuticals. In the provinces, each healthcare district has one district hospital. Burundi now has a total of 827 healthcare centres compared to 200 a few years ago.
European Times: What are the top priorities of the Ministry of Health?
Dr. Sabine Ntakarutimana: The main mission of our ministry is to fight against diseases with high mortality rates, such as malaria, respiratory infections, diarrheal diseases and HIV/AIDS, as well as chronic, non-infectious health problems which are becoming increasingly common in Burundi as the country’s economy develops, including high blood pressure, diabetes and heart disease. We also support continuing immunisation efforts; Burundi has already achieved a 90% immunisation rate for children.
European Times: What are some of your current projects?
Dr. Sabine Ntakarutimana: As part of our efforts to combat malaria, we distribute mosquito nets impregnated with insecticide. We are also developing a research centre in the province of Bubanza to focus on mosquitoes and new ways of cutting the chain of transmission of mosquitoborne illnesses. We are building a new hospital in Karusi province which will serve patients referred to it from all over the country, and we have many programmes to combat AIDS and make treatment available to more HIV patients.
European Times: What are some major recent steps forward in the healthcare sector?
Dr. Sabine Ntakarutimana: In addition to our great progress in immunisation, we have provided free healthcare for children under five and for pregnant women since 2006. As a result, the maternal mortality rate has decreased from 614 deaths per 100,000 births to 499 deaths per 100,000 births, and now 70% of mothers give birth in hospitals compared to 34% in 2005. If we continue to improve at this rate, we will reach the Millennium Development Goals by 2015. We have also made progress in the availability of pharmaceuticals, and the private pharmaceuticals sector is growing. We are gradually bringing healthcare services which meet World Health Organisation standards to people throughout the country.
European Times: What are the main challenges your ministry faces?
Dr. Sabine Ntakarutimana: A major challenge is Burundi’s high population growth rate, which has reached around 6.4 children per mother. We have initiated a project which aims to reduce this to three children per mother by 2025. We are working to increase the use of contraceptives and to promote smaller families, but birth control is culturally complex in an African country since having large numbers of children is considered an asset. Another huge challenge is to provide healthcare to people living in poverty. To cope with this, the ministry is developing a health card aimed at broadening access to healthcare among disadvantaged members of the population. We want to move towards universal healthcare coverage. Upgrading the quality and number of our healthcare professionals is another top priority. Many doctors and other healthcare professionals have left the country to work in France or other places where they can gain higher revenues and work in better conditions. We are developing programmes in capacitybuilding to improve the working environment for healthcare professionals and we are also promoting higher wages for them. Another specific challenge is that around 58% of the children under five in this country are malnourished, and we are developing programmes to cope with this.
European Times: What are your goals for the future?
Dr. Sabine Ntakarutimana: In addition to working to meet the challenges I have mentioned, we are currently assessing the progress that has been made in our National Health Development Plan for 2011 to 2015, which is budgeted at €22.9 million. We are receiving support for our healthcare programmes from the World Bank, the EU and other funding sources, and the government of Burundi has increased its support for healthcare from 4% of the annual state budget in 2005 to 11% today. We want to improve the quality of our hospitals and healthcare centres by investing in new equipment and technologies, and we also aim to further decentralise the healthcare system to increase and improve services for rural residents. Another priority is to boost our support for preventative healthcare. Burundi’s healthcare system has been greatly improved in the past few years but it still needs significant investment and support from the public and private sectors.