A Comparison of Health Achievements in Rwanda and Burundi

Strong primary health care systems are essential for implementing universal health coverage and fulfilling health rights entitlements, but disagreement exists over how best to create them. Comparing countries with similar histories, lifestyle practices, and geography but divergent health outcomes ca...

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Main Authors:	Iyer, Hari S., Chukwuma, Adanna, Mugunga, Jean Claude, Manzi, Anatole, Ndayizigiye, Melino, Anand, Sudhir
Format:	Journal Article
Published:	FXB Harvard School of Public Health 2021
Subjects:	PRIMARY HEALTH CARE UNIVERSAL HEALTH COVERAGE HEALTH RIGHTS HEALTH OUTCOMES LIFE EXPECTANCY EQUITY ACCESS TO HEALTH SERVICES
Online Access:	http://hdl.handle.net/10986/35577

id	okr-10986-35577
recordtype	oai_dc
spelling	okr-10986-355772021-07-19T16:44:32Z A Comparison of Health Achievements in Rwanda and Burundi Iyer, Hari S. Chukwuma, Adanna Mugunga, Jean Claude Manzi, Anatole Ndayizigiye, Melino Anand, Sudhir PRIMARY HEALTH CARE UNIVERSAL HEALTH COVERAGE HEALTH RIGHTS HEALTH OUTCOMES LIFE EXPECTANCY EQUITY ACCESS TO HEALTH SERVICES Strong primary health care systems are essential for implementing universal health coverage and fulfilling health rights entitlements, but disagreement exists over how best to create them. Comparing countries with similar histories, lifestyle practices, and geography but divergent health outcomes can yield insights into possible mechanisms for improvement. Rwanda and Burundi are two such countries. Both faced protracted periods of violence in the 1990s, leading to significant societal upheaval. In subsequent years, Rwanda’s improvement in health has been far greater than Burundi’s. To understand how this divergence occurred, we studied trends in life expectancy following the periods of instability in both countries, as well as the health policies implemented after these conflicts. We used the World Bank’s World Development Indicators to assess trends in life expectancy in the two countries and then evaluated health policy reforms using Walt and Gilson’s framework. Following both countries’ implementation of health sector policies in 2005, we found a statistically significant increase in life expectancy in Rwanda after adjusting for GDP per capita (14.7 years, 95% CI: 11.4–18.0), relative to Burundi (4.6 years, 95% CI: 1.8–7.5). Strong public sector leadership, investments in health information systems, equity-driven policies, and the use of foreign aid to invest in local capacity helped Rwanda achieve greater health gains compared to Burundi. 2021-05-14T15:38:45Z 2021-05-14T15:38:45Z 2018-06 Journal Article Health and Human Rights http://hdl.handle.net/10986/35577 CC BY-NC-ND 3.0 IGO http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank FXB Harvard School of Public Health Publications & Research :: Journal Article Publications & Research Africa Africa Eastern and Southern (AFE) Burundi Rwanda
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	PRIMARY HEALTH CARE UNIVERSAL HEALTH COVERAGE HEALTH RIGHTS HEALTH OUTCOMES LIFE EXPECTANCY EQUITY ACCESS TO HEALTH SERVICES
spellingShingle	PRIMARY HEALTH CARE UNIVERSAL HEALTH COVERAGE HEALTH RIGHTS HEALTH OUTCOMES LIFE EXPECTANCY EQUITY ACCESS TO HEALTH SERVICES Iyer, Hari S. Chukwuma, Adanna Mugunga, Jean Claude Manzi, Anatole Ndayizigiye, Melino Anand, Sudhir A Comparison of Health Achievements in Rwanda and Burundi
geographic_facet	Africa Africa Eastern and Southern (AFE) Burundi Rwanda
description	Strong primary health care systems are essential for implementing universal health coverage and fulfilling health rights entitlements, but disagreement exists over how best to create them. Comparing countries with similar histories, lifestyle practices, and geography but divergent health outcomes can yield insights into possible mechanisms for improvement. Rwanda and Burundi are two such countries. Both faced protracted periods of violence in the 1990s, leading to significant societal upheaval. In subsequent years, Rwanda’s improvement in health has been far greater than Burundi’s. To understand how this divergence occurred, we studied trends in life expectancy following the periods of instability in both countries, as well as the health policies implemented after these conflicts. We used the World Bank’s World Development Indicators to assess trends in life expectancy in the two countries and then evaluated health policy reforms using Walt and Gilson’s framework. Following both countries’ implementation of health sector policies in 2005, we found a statistically significant increase in life expectancy in Rwanda after adjusting for GDP per capita (14.7 years, 95% CI: 11.4–18.0), relative to Burundi (4.6 years, 95% CI: 1.8–7.5). Strong public sector leadership, investments in health information systems, equity-driven policies, and the use of foreign aid to invest in local capacity helped Rwanda achieve greater health gains compared to Burundi.
format	Journal Article
author	Iyer, Hari S. Chukwuma, Adanna Mugunga, Jean Claude Manzi, Anatole Ndayizigiye, Melino Anand, Sudhir
author_facet	Iyer, Hari S. Chukwuma, Adanna Mugunga, Jean Claude Manzi, Anatole Ndayizigiye, Melino Anand, Sudhir
author_sort	Iyer, Hari S.
title	A Comparison of Health Achievements in Rwanda and Burundi
title_short	A Comparison of Health Achievements in Rwanda and Burundi
title_full	A Comparison of Health Achievements in Rwanda and Burundi
title_fullStr	A Comparison of Health Achievements in Rwanda and Burundi
title_full_unstemmed	A Comparison of Health Achievements in Rwanda and Burundi
title_sort	comparison of health achievements in rwanda and burundi
publisher	FXB Harvard School of Public Health
publishDate	2021
url	http://hdl.handle.net/10986/35577
_version_	1764483365024563200

A Comparison of Health Achievements in Rwanda and Burundi

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