Strengthening health care structures for family planning and for sexual and reproductive health and rights

Project description

Title: Strengthening health care structures in the field of family planning and sexual and reproductive health and rights (SRHR)
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Burundi
Lead executing agency: Ministère de la Santé Publique et de la Lutte contre le SIDA (Ministry of Public Health and the Fight Against AIDS – MSPLS)
Overall term: 2012 to 2016

Burundian nurse. © GIZ

Context

Scarcity of land and the resulting population pressure are becoming a matter of serious concern in Burundi, which now has a population density of 310 people per square kilometre. In 2010, the average birth rate was 6.4 children per woman. Only just under 30 per cent of the population uses family planning methods. This population growth is putting pressure on the country's natural and economic resources, and the school and health care systems are barely able to cope.

Almost half of Burundi's population is younger than 15. Gender-based violence against women and girls is widespread. Sociocultural factors prevent Burundi from taking a positive approach to topics such as sex education and family planning. In view of this situation, the Burundian Government has identified efforts to curtail population growth and to promote sexual and reproductive health as national priorities. It also aims to promote respect for the associated rights.

Objective

Key actors implement customised and appropriate approaches to improving sexual and reproductive health and rights (SRHR).

Approach

The programme forms part of the country's National Development Plan and assists the National Reproductive Health Programme in implementing its strategy. It operates at national level and in the provinces Mwaro, Muramvya and Gitega, comprising three fields of activity:

  1. Strengthening national resources in training and continued education on SRHR

    The programme supports the Institut National de Santé Publique (National Institute of Public Health – INSP) in improving training and continued education on SRHR. Existing elements are being updated and consolidated, and missing modules are being integrated into the training courses. A quality assurance system is being introduced based on self-assessment by the teaching staff. This field of activity is being implemented by GFA Consulting Group.

  2. Improving intrasectoral and intersectoral cooperation and coordination in the field of SRHR

    Burundian non-governmental organisations (NGOs) are receiving support in implementing appropriate projects to raise awareness among the population. An interfaith working group is seeking to improve dialogue between officials in the health care sector and religious dignitaries. Networks are being set up in which churches, clubs, schools, NGOs, the local authority and health care staff can share ideas and experience and organise activities.

  3. Developing and assuring the quality of inclusive and integrated SRHR services

    The partners in the health care system are being assisted in recognising critical shortcomings in SRHR services and in developing and implementing strategies to resolve them. A voluntary quality competition is being introduced in the health centres to encourage them to identify need for improvement and to carry out the relevant measures. Health centres are being promoted to help them be recognised as 'youth-friendly' centres.

Results

Key reference documents for training have been drawn up in collaboration with the teaching staff at INSP. Teachers now complete self-assessments, which are used as the basis for in-service training measures.

A total of 730 peer educators and social workers have completed a training course on SRHR and have reached more than 38,000 people. Seventy clubs in schools and communities are writing plays and songs and inventing dances to raise awareness in their communities. Young Jesuits, Muslims and Protestants are joining forces to encourage people to talk openly about this taboo subject. Girls who have had unwanted pregnancies have set up an association and are getting involved in schools and communities as peer educators. A total of 38 networks are currently being set up.

Burundi © GIZ

More than 60 health centres are taking part in a quality competition, the concours qualité, focusing on 'cleanliness and hygiene' and on 'user-friendliness and patient waiting times'. Initial results from 32 centres show that they can measurably improve quality through their own efforts. This is a key basis for lasting improvements.