IMPROVING MATERNAL HEALTH SERVICES PERFORMANCE USING SOCIAL ACCOUNTABILITY IN BURUNDI.
Summary
Although maternal health was declared a top governmental priority in Burundi, progress made towards maternal health services strengthening is deemed to be less than expected. In fact, despite the implementation of free care for pregnant women, the decentralization of health services, the adoption of the performance-based financing scheme to motivate the health staff, the rehabilitation of the health infrastructure, the increase of the number of schools to train midwives, Burundi is still experiencing an insufficient maternal health services utilization and a high maternal mortality contrasting with efforts made. Possible reasons explaining the situation is the way services provision is organized and the quality of encounters between health providers, women and their relatives. In fact, evidence has shown that health infrastructure and personnel availability does not lead always to improved health for users. The way health care is provided matters and the level to which it meets user’s expectations which most of the time are influenced by the local culture and traditions is also to consider.