Partnership first: How Local Leadership in the Private Sector Could Lead to Better Access to Health Care in Burundi

This piece was originally featured on the USAID MOMENTUM blog.

A robust national health system requires cooperation and strong dialogue between the public and private sectors, ensuring that all local actors play a role in increasing access to essential health services.

MOMENTUM has partnered with two organizations in Burundi that specifically support private sector health providers, forging a promising path to locally owned and sustainable solutions for broader access to voluntary family planning and reproductive health (FP/RH) in the country.

Half of the primary-level health facilities in Burundi are privately operated. According to 2016-2017 data from the Demographic and Health Survey, 14 percent of women who used a modern contraceptive method obtained it from a private source. While the country has made progress in increasing overall modern contraceptive use, about one-third of married women want to stop or delay childbearing, but do not use family planning. There is a valuable opportunity to leverage the potential of Burundi’s private sector to reach more individuals.

How can Burundi better integrate the private sector into efforts to fill this gap in quality family planning provision? And what role can local actors play in this effort?

Leveraging the strengths of local private sector organizations

Both Burundian organizations have deep connections to the diverse set of private providers in the country: the Association Nationale pour la Franchise Sociale (ANFS, National Association for Social Franchise), a network composed of independent private health clinics; and the Réseau des Confessions Religieuses pour la promotion de la Santé et le bien-être intégral de la famille (RCBIF), a community-based organization that works with faith-based health clinics throughout the country and across four religious denominations to provide a range of primary health services.

MOMENTUM’s partnership with these organizations will help clinics improve the quality of counseling and support to clients and an expanded range of contraceptive methods. By 2025, this partnership will assist 250+ health facilities to improve their service delivery capacity and reach to surrounding communities not only with FP/RH care, but also a broad range of primary health care services.

This partnership also directly aligns with Burundi’s National Health Policy objectives to improve private sector participation in the provision of health services to the entire population.

Women and their children wait to be seen at a health clinic in Burundi. Credit: EC/ECHO/Martin Karimi

Partnering involves building both skills and trust

Working with ANFS and RCBIF, and in close collaboration with the Burundian Ministry of Health, MOMENTUM helps both organizations build the technical and clinical capacity of private health care providers at health facilities to deliver evidence-based, quality FP/RH services.

Through a “learn by doing” approach, the staff gains skills and confidence that can be passed on. For example, MOMENTUM mentors ANFS and RCBIF teams on supportive supervision tools that emphasize putting the client’s preferences and needs first when counseling and delivering FP services. Supervisors can then tailor the advice and support they provide to the needs of different facilities and their frontline health workers.

Both organizations played a critical role in identifying the health facilities that MOMENTUM will support with capacity-building efforts. RCBIF’s involvement, for instance, secured the necessary endorsements and created a foundation of trust for individual health facilities to participate in the project’s baseline assessment. In fact, “it would have been impossible without their support,” noted Lydia Gahimbare, PSI Burundi’s Director of Private Sector Projects.

Sustaining access over the long term by investing in private sector capacity building

MOMENTUM is supporting institutional development plans for ANFS and RCBIF as well. As a result, they will have a stronger organizational infrastructure to help sustain the private sector’s progress in providing equitable, high-quality FP/RH services to women and their families in future years.

The long-term and multifaceted nature of the partnership between MOMENTUM and both organizations reflects the two-way exchange of expertise at the heart of locally-led development and effective FP/RH health care delivery tailored to the country context.

MOMENTUM’s investment in local organizations and private sector capacity building is “tantamount to strengthening Burundi’s health system,” says André Bizoza, RCBIF’s Executive Director. “Most importantly, it enables the poorest to access quality health services.”

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