1. Presented by
Raphael Bajay Tchumah, COP Tubaramure - CRS
Evelyn Ngomirakiza, National Director-Pronianut – MOH GOB-Burundi/
Basile Ndumbi Mukenge, Country Director IMC
Core group meeting, Silver Spring, May 7, 2014

2. Burundi: country profile and context
Burundi: CRS-IMC-MoH 2
• Population: 10.88 millions
• Administration: 17 provinces
• UNDP Rank: 178 out of 187
• HDI value : 0.335 (average of 0.475
for subsaharan countries)
• Civil conflict from 1993 to 2005
• Disruption of public services and
private investments
• Extreme poverty: < $1.25 per day
for 80% of the population
• Nutrition (DHS 2010) : 58% Stunting
29% Underweight 6% Wasting and
11% Low birth rate

3. Burundi: 2004 to 2008
Burundi: CRS-IMC-MoH 3
General state of nutrition:
• Post conflict period: IDPs, returnees, high food insecurity
• Emergency and recuperative programs (WFP….)
• No national orientation or guidelines on maternal and child nutrition
• Lack of coordination for nutrition responses among INGOs and GOB
• Small MOH department of nutrition in a multisectoral direction
NGO-based Nutrition interventions:
• Médecins-Sans-Frontières,(MSF) IMC, ACF, etc
• Supplementation for more than 100,000 children per year (2007-2008)

4. State of children 2008
Burundi: CRS-IMC-MoH 4

5. 2008-2009: Startup
(MOH treatment-oriented programs)
Burundi: CRS-IMC-MoH 5
Health Facility based-activities:
• Monitoring and Early warning for malnutrition cases through
Integrated Child and maternal services
• Reference of malnourrished children
• Specific services: SFP, OTP and SSt
• Products: F75, F100, Plumpynut, CSB/Veg oil, etc
Community based activities:
• Recuperative approach through PD/Hearth
• Preventive approach through Food security activities, SBCC, care group,
and SILC/IGA solidarity chain (goats), selected seeds, home visits/CHW
(gender sensitive approaches)
• Community screening: CHWs

6. Initial protocol for treating SAM in
Burundi
Burundi: CRS-IMC-MoH 6
• REPUBLIQUE DU BURUNDI
• MINISTERE DE LA SANTE PUBLIQUE
• PROGRAMME DE LUTTE CONTRE LES MALADIES
• TRANSMISSIBLES ET CARENTIELLES
•
•
• PROTOCOLE NATIONAL DE PRISE EN CHARGE INTEGREE
• DES CAS DE MALNUTRITION AIGUE
•
•
•
•
•
•
Mai 2008

7. 2008-2009: A change year
Burundi: CRS-IMC-MoH 7
• 2008: CRS led with a consortium partner IMC implement
the first Title II program in Burundi (MYAP-1), a
recuperative program through Health structures and
Positive Deviance HEARTH.
• 2008: MOH and CONCERN Worldwide did First Pilot
CMAM/CTC in Muyinga,
• 2009: Integrated National Program for Food and Nutrition
(PRONIANUT).

8. 2008: 1st Title II MYAP for Burundi
Burundi: CRS-IMC-MoH 8
MYAP-1 objective: to reduce chronic and transitory food
insecurity in the northern of Burundi (Kayanza, Kirundo and
Muyinga):
*** A combination of curative and preventive activities ***
• Curative: stabilization services, OTP, SFP, PLWHIV, etc
• Preventive: care groups, PDH, PHAST methodology, and
other Food security activities (SBCC, SILC/IGA solidarity chain
(goats), Community screening by trained CHWs

9. Coverage of existing programs in 2008
Burundi: CRS-IMC-MoH 9
• All operating programs were limited to some province:
less than 10 out of 17 provinces in need.
• Political circumstances limited INGO engagement
throughout country.

10. 2009: enter the PM2A Burundi
Burundi: CRS-IMC-MoH 10
A new partnership with the Government of Burundi
• CRS and consortium partners engaged Government and
stakeholders at national, provinicial and local levels in design of
TUBARAMURE, « Let US help them grow
• Continual dialogue with MOH, USAID and Tubaramure partners
on the roll out and activities of the project including
– Sharing of site visits with the MOH
– Resolution of questions and concerns about the protocols of blanket
feeding and the research
– Close collaboration for the production of training modules, key program
messaging and the strenghtening of local capacities, etc.

11. USAID FFP PM2A in Burundi
SO: Malnutrition in
children under 2 years
of age is prevented in
Burundi
IR1: Access to quality
health services
IR2: Individual
behaviours
IR3: Adequate food

12. PM2A key achievements
Burundi: CRS-IMC-MoH 12
Transferring capacity to the MoH, and the community:
• IMCI Training of Health Facilities staff: from 0 in 2010 to 130
nurses from 60 Health Centers and 10 Medical Doctors from 5
districts/provincial hospitals.
• Linking MCHN services to Community Growth Monitoring
• Tubaramure: a public model for preventing malnutrition for
under two children.
• With the PM2A direct/indirect contribution: the IMCI national
protocol, the IYCF guideline, the ANC and PNC protocols have
been elaborated and widely disseminated…
• Participation and close collaboration in the SUN movement

13. PM2A key achievements
Burundi: CRS-IMC-MoH 13

14. The way forward
Burundi: CRS-IMC-MoH 14
During life of Tubaramure the GoB developed a
set of National strategies that all INGOs now
adhere to…
• Poverty Reduction Strategy Paper II (International
Monetary Fund, 2012)
• National Health Development Plan (2011-2015)
• National Agriculture Investment Plan (2012-2017)
• Multi-Sector Strategic Plan to Fight Malnutrition (2013
to 2017

15. By 2014…
Burundi: CRS-IMC-MoH 15
• Burundi joined the SUN movement (2013)
• Increased levels of trained staff in prevention approach.
• the coordination mechanism has been set up through the
SUN and REACH movements.
• the National Integrated Program of Food and Nutrition is
exercising leadership role
• National action plan for 2014 includes fortification
interventions
• Lower demands for imported food aid and more demand for
local foods and nutrition security interventions

16. This presentation is made
possible by the generous
support of the American
people through the
support of the Office of
Food For Peace Office
under terms of
Cooperative Agreement
No. AID-FFP-09-00004-00
through the Catholic relief
services.
16
THANK YOU