In the rural hills of Cibitoke Province, Burundi, accessing a public health clinic was rarely a simple task. Families often walked long distances across challenging terrain to receive basic medical care. Where physical infrastructure was limited, the true key to saving lives lay within the community itself—in the hands of dedicated local nurses, volunteers, and village leaders.
Through the GSK 20% Re-Investment Initiative, implemented by ADRA Burundi in partnership with Amref Health Africa, a quiet health revolution took place. Over the course of a year (June 2018 – May 2019), a collaborative project focused heavily on health promotion, capacity building, and behavioural change, transforming how health services were understood and delivered in the province and the country at large.
Empowering the Frontlines
Change began with robust data and skilled professionals. The project shattered its annual capacity-building goals by training 92 frontline medical practitioners on strategic planning and data analysis—reaching an impressive 153.3% of its target. By providing doctors and nurses with the tools to track medical trends, health centres became better prepared to respond to localized health risks.
Simultaneously, the initiative trained 378 community leaders, including Community Health Workers (CHWs), religious leaders, and local administrative authorities. These stakeholders received targeted training on essential health topics, including family planning, modern nutritional strategies, and the Ministry of Public Health’s official community guidelines.
From Classrooms to Cooking Pots: Action in the Community
True development was not just about training inside rooms; it was about changing behaviours in households. To combat stubborn malnutrition rates, ADRA Burundi organized 37 live cooking demonstrations across local villages. During these interactive sessions, mothers and caregivers learned to utilize locally available, affordable ingredients to prepare balanced, nutrient-dense meals for growing children.
Furthermore, 84 community dialogues were carried out across the province. An inspiring 54 of these sessions were launched entirely through the self-driven initiative of local health networks, proving that the seeds of independence had successfully taken root. These dialogues created safe, open spaces for communities to openly debate topics once considered sensitive, such as family planning protocols, HIV/AIDS awareness, and basic hygiene practices.
Clean Sanitation via the CLTS Approach
Hygiene served as the foundation of preventive health. In Buganda Commune, the project deployed the Community-Led Total Sanitation (CLTS) approach. Local networks mobilized to conduct a comprehensive basic sanitation survey across households, public schools, and local businesses to tackle open-air defecation. While the approach was widely celebrated by residents as a vital remedy for waterborne illness, ADRA continued to advocate for deeper resources to scale all steps of this program across wider regions of the province.
The Power of Ownership
The project’s progress highlighted a crucial lesson: sustainability relied on local ownership. By shifting community dialogues to the afternoons, the project adapted to the agricultural schedules of rural farmers, which led to record-high participation. Moreover, by involving local government and religious leaders, ADRA Burundi ensured that health advocacy was backed by community authority.
As the GSK Re-Investment Initiative moved forward, ADRA Burundi remained committed to working hand-in-hand with the Ministry of Public Health and rural families, ensuring that every household in Cibitoke possessed the knowledge and support to lead a healthy, dignified life.
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