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African Journal of Emergency Medicine. 2023;13(4):300-305. doi:10.1016/j.afjem.2023.09.005. https://europepmc.org/articles/PMC10582767?pdf=render", "country_ids": [ "BDI" ], "coverage_domains": [ "facility_data", "hospital_organization", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "Forty of 45 district hospitals completed the survey", "institution": "African Journal of Emergency Medicine", "locator": { "locator_type": "article_pages", "source_word_anchor": "Forty of 45 district hospitals completed the survey", "source_word_count": 9 }, "material_id": "material:442c8aa3fae2f6fb708d0c5c", "notes": [ "Keep June 2022 self-reported survey scope and non-response explicit; do not generalize equipment findings to all service domains." ], "origin": "country-evidence-improvement-sources", "period": "online hospital survey, June 2022", "publication_date": null, "publication_year": 2023, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "41a3dea0c60440eb65201b625187ebe1e675e447f6d5c9801b7f7ec4bba1db8e", "page_count": 6, "response_sha256": "41a3dea0c60440eb65201b625187ebe1e675e447f6d5c9801b7f7ec4bba1db8e" }, "statement": "A cross-sectional survey received complete responses from 40 of 45 district hospitals. The authors describe a four-level referral chain and report uneven emergency staffing, imaging and equipment. Survey responses are facility self-reports and do not measure actual referral completion.", "tags": [], "territory": "district hospitals nationally; 40 responding hospitals represented 90% of the population", "title": "Essential human and material resources for emergency care in the district hospitals of Burundi", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://europepmc.org/articles/PMC10582767?pdf=render" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Bank Independent Evaluation Group. Health System Support Project (KIRA) (P156012): Implementation Completion Report Review, ICRR0024014. Washington, DC: World Bank; 2024. https://documents.worldbank.org/curated/en/099070724235531540/pdf/P156012-1acfd1db-2ed5-4355-83ee-aaeef2ac0ab4.pdf", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "governance", "market_structure", "networks", "observed_referral", "ownership", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "reinforced the referral system between communities and health centers", "institution": "World Bank Independent Evaluation Group", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "reinforced the referral system between communities and health centers", "source_word_count": 9 }, "material_id": "material:645e4024261a158a63f5851f", "notes": [ "Preserve project scope, the reported rather than independently audited status of results, and the distinction between referrals and a national patient-flow rate." ], "origin": "country-evidence-improvement-sources", "period": "project implementation through closure on 2023-06-30; review published 2024", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "21ee8f699b74d77e2f482e03d303e9a3bf50f18ca510ae6d9582545acb645319", "page_count": 21, "response_sha256": "21ee8f699b74d77e2f482e03d303e9a3bf50f18ca510ae6d9582545acb645319" }, "statement": "The completion review reports performance-based payments to selected public, private and non-profit providers. It reports that community health-worker groups, each linked to one health centre, operated in 13 provinces in 2022 and strengthened community-to-centre referral. Project results must not be treated as all-country causal estimates.", "tags": [], "territory": "project-supported facilities and community groups; provincial expansion described in the review", "title": "Health System Support Project (KIRA): Implementation Completion and Results Review", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://documents.worldbank.org/curated/en/099070724235531540/pdf/P156012-1acfd1db-2ed5-4355-83ee-aaeef2ac0ab4.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Republic of Burundi, Ministry of Public Health and the Fight Against AIDS. Normes sanitaires pour la mise en œuvre de la stratégie sectorielle du MSPLS 2021-2027, Tome 3: Niveau central, administration centrale, hôpital de référence nationale et secteur privé. Bujumbura; May 2022. https://minisante.gov.bi/wp-content/uploads/document_valide/TOME-3-NORMES%20SANITAIRES_Mai_2022_Pr%C3%A9fac%C3%A9.pdf", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Le système de santé est organisé sous forme pyramidale", "institution": "Ministry of Public Health and the Fight Against AIDS, Republic of Burundi", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "Le système de santé est organisé sous forme pyramidale", "source_word_count": 10 }, "material_id": "material:1cb05b41750f33c344ed071b", "notes": [ "Keep standards and intended referral architecture separate from observed patient movement or current facility counts." ], "origin": "country-evidence-improvement-sources", "period": "2021-2027 sector-strategy implementation standards, published 2022", "publication_date": null, "publication_year": 2022, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "6f499df4593ede7c54c215753ae24bd20df299e5b4323bd126b58082938b07d0", "page_count": 151, "response_sha256": "6f499df4593ede7c54c215753ae24bd20df299e5b4323bd126b58082938b07d0" }, "statement": "The standards organize care through community, peripheral, intermediate and central levels, set a hierarchical referral and counter-referral network, and describe third-referral and national hospitals as public entities with administrative and financial management autonomy. They also state that private facilities complement public supply and remain subject to public directives.", "tags": [], "territory": "national standards; third-referral hospitals serve stated multi-province areas", "title": "Health standards for implementing the 2021-2027 sector strategy, Volume 3", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://minisante.gov.bi/wp-content/uploads/document_valide/TOME-3-NORMES%20SANITAIRES_Mai_2022_Pr%C3%A9fac%C3%A9.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Bank. Analyse institutionnelle et organisationnelle des capacités du Burundi à prévenir, détecter et répondre efficacement aux épidémies-pandémies. Report AUS0003270. Washington, DC: World Bank; 2023. https://documents.worldbank.org/curated/en/099050923073514163/pdf/P175128-d8eb0415-08b0-4ca4-ba43-35a2ac93d962.pdf", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "autonomy", "decision_rights", "facility_data", "governance", "government_responsibilities", "market_structure", "networks", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Le district sanitaire constitue le niveau opérationnel du système de santé", "institution": "World Bank", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "Le district sanitaire constitue le niveau opérationnel du système de santé", "source_word_count": 11 }, "material_id": "material:89eb25bc949db38c51713bcc", "notes": [ "Limit claims to preparedness and epidemic-response arrangements; recommendations do not demonstrate later implementation." ], "origin": "country-evidence-improvement-sources", "period": "assessment published March 2023; evidence timing varies by component", "publication_date": null, "publication_year": 2023, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "40944f73a67fd30be823cd2ac156c10ad0bc328eeda6d905e89937ba2b1bbbd0", "page_count": 49, "response_sha256": "40944f73a67fd30be823cd2ac156c10ad0bc328eeda6d905e89937ba2b1bbbd0" }, "statement": "The assessment identifies the health district as the operational level for rapid intervention teams and notes that the National Institute of Public Health has management autonomy while reporting preparedness constraints. Its private-provider recommendations are prospective rather than evidence of adoption.", "tags": [], "territory": "national preparedness assessment, with district and provincial observations", "title": "Institutional and organizational analysis of Burundi's capacity to prevent, detect and respond to epidemics and pandemics", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://documents.worldbank.org/curated/en/099050923073514163/pdf/P175128-d8eb0415-08b0-4ca4-ba43-35a2ac93d962.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Waithaka D, Cashin C, Barasa E. Is performance-based financing a pathway to strategic purchasing in sub-Saharan Africa? A synthesis of the evidence. Health Systems & Reform. 2022;8(2):e2068231. doi:10.1080/23288604.2022.2068231. https://ora.ox.ac.uk/objects/uuid:47e96c3e-227c-4a08-a7a8-225fd6e54790/files/s9593tw18p", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "primary_care", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "limited their autonomy and ability to respond to shortages", "institution": "Health Systems & Reform", "locator": { "locator_type": "article_page_anchor", "page": 6, "section": "Health Provider Autonomy", "source_word_anchor": "limited their autonomy and ability to respond to shortages", "source_word_count": 9 }, "material_id": "material:1e9f6967f5e45f842790249d", "notes": [ "Retain the review's search end date and indirect evidence basis; annotate newer Burundi-specific evidence separately." ], "origin": "country-evidence-improvement-sources", "period": "review search covered English-language evidence from 2000 to 2020; published 2022", "publication_date": null, "publication_year": 2022, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "386c3e67d80a782f469ccca5335479b522dab301b301c063dd827fb2707dc8ae", "page_count": 14, "response_sha256": "386c3e67d80a782f469ccca5335479b522dab301b301c063dd827fb2707dc8ae" }, "statement": "The synthesis reviewed 44 papers and reports that, in Burundi, performance-financed facilities had to request medicines and staff through district managers, a reportedly time-consuming process that limited autonomy and response to shortages. This is review-level, period-bound evidence rather than a current national estimate.", "tags": [], "territory": "Burundi evidence within a sub-Saharan African evidence synthesis", "title": "Is performance-based financing a pathway to strategic purchasing in sub-Saharan Africa?", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://ora.ox.ac.uk/objects/uuid:47e96c3e-227c-4a08-a7a8-225fd6e54790/files/s9593tw18p" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Republic of Burundi. Loi No. 1/012 du 30 mai 2018 portant Code de l'offre des soins et services de santé au Burundi. Bujumbura; 2018. https://extranet.who.int/cpcd/sites/default/files/public_file_repository/BDI_Burundi_Code-de-l_offre-des-soins-et-services-de-sante-au-Burundi_2018.pdf", "country_ids": [ "BDI" ], "coverage_domains": [ "autonomy", "decision_rights", "governance", "hospital_organization", "market_structure", "ownership", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Etablissement de droit public ou privé doté d'une autonomie de gestion", "institution": "Republic of Burundi", "locator": { "locator_type": "legal_articles", "source_word_anchor": "Etablissement de droit public ou privé doté d'une autonomie de gestion", "source_word_count": 11 }, "material_id": "material:ef65bda0ab4a0c3a2b45d270", "notes": [ "This is a formal legal architecture. Do not infer the present extent of facility autonomy or private-provider activity without implementation evidence." ], "origin": "country-evidence-improvement-sources", "period": "adopted 2018-05-30; current consolidated validity is not independently established", "publication_date": null, "publication_year": 2018, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "78cc380cc3eece81e9ccd0bee282ed8fadad31b2a77b2e60217abe36eaf1abb8", "page_count": 75, "response_sha256": "78cc380cc3eece81e9ccd0bee282ed8fadad31b2a77b2e60217abe36eaf1abb8" }, "statement": "The code applies to public authorities, territorial communities, professionals and public or private health enterprises. It defines primary, provincial and national referral care, requires continuity to another establishment where needed, and gives public health establishments administrative and financial autonomy under a board.", "tags": [], "territory": "national legal framework", "title": "Law No. 1/012 of 30 May 2018: Code of the provision of health care and services", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://extranet.who.int/cpcd/sites/default/files/public_file_repository/BDI_Burundi_Code-de-l_offre-des-soins-et-services-de-sante-au-Burundi_2018.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Republic of Burundi, Ministry of Public Health and the Fight Against AIDS. A propos: Organisation du système sanitaire. Current ministry webpage, retrieved 22 August 2026. https://minisante.gov.bi/?page_id=1664", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "governance", "government_responsibilities", "hospital_organization", "networks", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Le système de santé du Burundi est organisé sous forme pyramidale", "institution": "Ministry of Public Health and the Fight Against AIDS, Republic of Burundi", "locator": { "locator_type": "web_section", "section": "Organisation du système sanitaire", "source_word_anchor": "Le système de santé du Burundi est organisé sous forme pyramidale", "source_word_count": 11 }, "material_id": "material:69dbcaedba1c15bd256938eb", "notes": [ "Treat the current webpage as an administrative description; annotate any territorial exception or later reorganization." ], "origin": "country-evidence-improvement-sources", "period": "current webpage retrieved 2026-08-22", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "95c8e11f7d02e4f62a676210d5f2d7091c4073696846844899cbe7ea64b001e9" }, "statement": "The ministry describes a four-level pyramidal system: central bodies, 18 Provincial Health Offices, district-level services and community structures. The webpage is a current administrative description rather than a measured account of implementation.", "tags": [], "territory": "national, with central, provincial, district and community levels", "title": "Ministry of Public Health and the Fight Against AIDS: About", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://minisante.gov.bi/?page_id=1664" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Republic of Burundi, Ministry of Public Health and the Fight Against AIDS. Plan National de Développement Sanitaire, troisième génération: PNDS III 2019-2023. Bujumbura; 2018. https://files.aho.afro.who.int/afahobckpcontainer/production/files/PNDSIII__BURUNDI.pdf", "country_ids": [ "BDI" ], "coverage_domains": [ "actors", "facility_data", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Le système de santé du Burundi est organisé sous forme pyramidale", "institution": "Ministry of Public Health and the Fight Against AIDS, Republic of Burundi", "locator": { "locator_type": "pdf_page_set_anchor", "source_word_anchor": "Le système de santé du Burundi est organisé sous forme pyramidale", "source_word_count": 11 }, "material_id": "material:bdf5c1648b92add908da2d57", "notes": [ "The plan ended in 2023. Treat its facility counts, diagnoses and intended actions as period-bound unless a current source confirms them." ], "origin": "country-evidence-improvement-sources", "period": "plan period 2019-2023", "publication_date": null, "publication_year": 2018, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "9e3cf434bec29600e6a0d08b2a829cb1ff228ba7a54f0d9873ecc596369598f4", "page_count": 93, "response_sha256": "9e3cf434bec29600e6a0d08b2a829cb1ff228ba7a54f0d9873ecc596369598f4" }, "statement": "The expired plan described four organizational levels and five hierarchically linked care levels. It designated district hospitals as the first referral level from health centres, recorded public, faith-based and private hospitals, and identified weak private-sector involvement as a system constraint.", "tags": [], "territory": "national plan from central to community level", "title": "Third National Health Development Plan 2019-2023", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://files.aho.afro.who.int/afahobckpcontainer/production/files/PNDSIII__BURUNDI.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Health Organization Regional Office for Africa. Stratégie de Coopération Burundi-OMS 2024-2027. 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