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Free birth services in Burundi to help cut maternal and child deaths

© UNICEF Burundi/2006/Ajia
Carinne, 16, has been unable to pay her hospital bills but hopes to benefit from the Burundi Government’s new, free birth-services policy.
By  Olalekan Ajia

BUJUMBURA, Burundi, 11 May 2006 – In a recovery room at Burundi’s biggest hospital, the Prince Regent Charles, 18-year-old Jocelyne Ndayizeye’s face is a study in pain and triumph. Her son has been delivered by caesarian section and she has survived one of the country’s deadliest obstacle courses – giving birth to a child. In Burundi, mothers are congratulated for ‘crossing the abyss’.

Burundi has among the highest maternal and infant mortality rates in the world. But on the day Jocelyne gave birth, 1 May, President Pierre Nkurunziza announced free birth delivery services for pregnant women and medical care for all children under the age of five.

“I am happy,” says Jocelyne, “and I urge him to continue with his good policies.” 
Another giant step

Providing free birth delivery and child care services is the government’s first step in its ‘Road Map for the Reduction of Neonatal and Maternal Mortality’, a policy launched in February. Developed in collaboration with UNICEF, the UN Population Fund, the World Food Programme and the World Health Organization, the plan aims for a 75 per cent reduction in maternal deaths and a 50 per cent reduction in neonatal mortality by 2015.

UNICEF Representative in Burundi Catherine Mbengue congratulated the government, describing the announcement as another giant step following last year’s declaration of free primary education. She reaffirmed UNICEF’s commitment to the improvement of maternal and newborn health in the country.

Hospital directors report that registration for child delivery has doubled since 1 May and that more nursing mothers are flocking to health centres.

Need for training and supplies

But there are challenges to be addressed in light of the new policy. Existing health facilities may soon be overwhelmed by demand.  Beds, mattresses, delivery couches and other equipment are grossly inadequate, as are medical supplies. Health workers are not only inadequate in number but are already overworked.

“There is a real risk of deterioration in the quality of health services,” says UNICEF Burundi's Maternal and Neonatal Health Officer, Dr. Marie-Therese Baranyikwa. “There is therefore an urgent need for more, better-trained and better-motivated staff, and emergency medical supplies and equipment.”

UNICEF is already supplying medicine and maternity equipment, and training nurses and other health workers in 10 provinces. It is also supporting strategies to help mothers, families and communities recognize and take action on danger signs during pregnancy and childbirth.
Burundi needs an estimated $4 million to implement the ‘Road Map’ successfully between now and 2009.

Mothers were detained

Despite the free birth-services announcement, however, not all young mothers in Burundi are as pleased as Jocelyne Ndayizeye.

Not so happy is 16-year-old Carinne Naisha Nizigiyimana, whose son was delivered by caesarian in early April. Carinne has been in hospital detention since then for being unable to pay her bills. She is urging the government to extend the free birth relief to her and others who gave birth before the policy took effect.
Prior to 1 May, hundreds of newly delivered babies and their mothers were routinely detained for non-payment – especially women whose babies were delivered surgically. Caesarian operations cost up to $200, nearly six times the monthly income of the average government worker in a country whose population is largely rural, poor and dependent on subsistence agriculture.



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