PSI

Burundi’s history of ethnic tension and violent conflict has crippled its economy and infrastructure. Mortality rates in the small Eastern African nation are alarming – well above what’s associated with an emergency situation. 1 Thousands of Burunians died in mass slaughters in 1972 and 1993, thousands more die each year from infectious disease, and hundreds of thousands of Burundians live in a chronic state of instability without access to basic health care.

PSI began working in Burundi in 1990 – until political instability and civil war resulted in funding cuts and 1996 staff evacuation. However, its local affiliate (Population, Santé et Information) stayed on to continue raising HIV/AIDS awareness, promoting HIV prevention behaviors, and social marketing condoms. When staff returned in 2002, PSI/Burundi added malaria and diarrhea prevention to its platform.

Despite challenges, PSI/Burundi has achieved more than 100% of its targeted DALYs 2 since 2008 in four of its major intervention categories:

• HIV/AIDS – 110% (2,435 DALYs)
• Family planning – 110% (3,012 DALYs)
• Malaria – 102% (134,567 DALYs)
• Waterborne disease – 128% (663 DALYS)

1. 1. Source: “Burundi: a population deprived of basic health care,” British Journal of General Practice, August 2004.
2. 2. The DALY (Disability-Adjusted Life Year) is a widely-used, credible metric that was first developed by the World Bank and is now routinely relied upon in the public health community.

Health Areas

Child Survival, Diarrheal Disease, HIV, Malaria

Health Impact

PSI/Burundi estimates that in 2010, its products and services helped avert:

• 19,423 HIV & TB DALYs1
• 2,697 Reproductive Health DALYs
• 386,861 Malaria Control DALYs
• 2,707 Child Survival DALYs
1. 1. Source: The DALY (Disability-Adjusted Life Year) is a widely-used, credible metric that was first developed by the World Bank and is now routinely relied upon in the public health community.

Health Interventions

• Basic HIV Care and Prevention Package
• Family Planning/HIV Integration
• Cross-Generational Sex
• Delayed Sexual Debut
• Uniformed Services Personnel

Improving Health in Burundi

HIV/AIDS

PSI/Burundi uses mass communication and peer education to help improve access to condoms for all people. However, it uses specific strategies to target high-risk groups, including:

• Young people, ages 15 to 24: PSI/Burundi’s behavior change communication (BCC) interventions go beyond promoting consistent condom use, abstinence and mutual fidelity. BCC strategies also discourage relationships between older men and younger women (“cross-generational sex”) and encourage delayed sexual debuts. Since launching activities in Burundi, PSI has distributed about 20.5 million “Prudence®” condoms. "Prudence Class®," a new brand of condoms, was launched in 2009.
• Military personnel: PSI/Burundi opened a voluntary counseling and testing (VCT) center within the Ministry of National Defense Headquarters in 2007 and added a mobile center in 2009. The center – called “Akabanga®”, which means confidentiality – staffs well-trained counselors and lab technicians who provide high-quality services to soldiers and their families. Together, both VCT venues have tested more than 2,500 clients.

Malaria

Each year, about 2 million of Burundi's 7 million people fall sick from malaria. Young children and pregnant women are especially vulnerable. Malaria is responsible for 50% of all deaths among children under 5 and more than half of deaths among pregnant women. 1PSI/Burundi helps empower parents to keep their families safe by using impregnated insecticide mosquito bednets. Since 2003, PSI has distributed more than 666,000 mosquito nets in Burundi.

PSI/Burundi succeeds by collaborating closely with the Ministry of Health to distribute free bednets along with routine immunization services at public health centers. PSI/Burundi also socially markets low-cost bednets.

Diarrheal Diseases

PSI/Burundi is fighting diarrheal diseases – which afflict most children under age 5 – on several fronts, including:

• Social marketing of oral rehydration salts (0RS) to treat diarrhea-related dehydration under the Orasel® brand. More than 1.1 million Orasel® sachets have been distributed since 2004.
• Social marketing the Sûr’Eau® brand home-use water guard product – a solution of stabilized hypochloridrite sodium.
• A hygiene and sanitation project to prevent cholera in six endemic provinces. PSI/Burundi’s BCC strategies help raise awareness and distribute Sûr’Eau® and ORS.

1. 1. Source: World Health Organization country profile.

Target Populations

Youth, commercial sex workers, military, women of reproductive age and children under five