Burundi’s free healthcare struggle

Published on BBCnews, Sept. 23, 2009.

As international donors announce more funding for a campaign to build free health-care systems in the developing world, the BBC’s Prime Ndikumagenge reflects on the experience of Burundi, which has already benefited from the scheme.

It has been three years since children under five years of age and new mothers in Burundi were granted free access to medical care. When the scheme was set up, international donors pledged $40m (£24m) a year – and that figure is set to rise. It has come as a relief to many families in a country where the majority of people live on less than $1 a day. Before the changes many people could not afford to take their children to hospital …  

… Since the free service was introduced, the hospital has been overwhelmed by new patients. Some suggest the number of people seeking treatment increased five-fold after the changes came in. But the number of beds available – and the already insufficient number of nurses and doctors – remained the same. One doctor in another hospital says the number of caesarean sections has increased by more than seven times in recent years.

The doctor says they cannot escape from dealing with such cases. But he says they turn away dozens of people coming for consultations – not necessarily because they are exhausted, but because they are reluctant to take on more work. They believe the government did not consider increasing their salaries when it took a decision that doubled or even tripled their workload. So while free healthcare has positively changed the lives of millions of Burundian children and mothers, critics say the scheme should have been better planned and thought through more thoroughly before it was implemented. (full text).

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