Parents in Commune Bururi are reportedly being charged for medical services and required to purchase medications from pharmacies, despite an official policy of free healthcare. Residents on colline Tongwe, among other areas, are incurring costs for essential medical care. S. N. A resident of colline Tongwe, for instance, reportedly incurred expenses related to her childbirth. This situation contrasts sharply with the announced government policy designed to provide free healthcare services to the public. The charges are forcing families to bear unexpected financial burdens for medical necessities. Parents are forced to buy medications in pharmacies when they are not available in local health structures.
Residents Face Unexpected Costs
Triphanie Ntunzwenimana, a resident of Kajabure hill, stated that essential medications are frequently unavailable in local health structures. When complications arise during delivery, patients are often required to pay for specific care or face transfer to facilities where services incur charges. S. N. Expressed surprise at being asked to pay for services she understood had been free for many years. She was specifically asked to pay for gloves, cotton, and certain medications before the delivery of her second child. This situation directly contradicts the official policy of free healthcare.
Ntunzwenimana recounted a personal experience involving her child, saying, "Cela m’est arrivé. Parfois, par gêne, on vous donne un seul comprimé et vous vous demandez comment faire avaler un comprimé à un bébé qui n’a même pas un an." She explained that medications are often unavailable in health structures, leading to such difficult scenarios.
Ntunzwenimana acknowledged that deliveries are generally covered without charge. However, the current situation reportedly weighs heavily on families with modest incomes. The necessity to purchase medications from pharmacies or pay for specific care when complications arise adds significant financial strain to already struggling households. This burden is particularly acute for those who had expected services to be entirely free, as per government assurances. Decree n°100/136, signed on June 16, 2006, mandates 100% coverage for deliveries, including C-sections, and care for children under five in public health facilities. The current reported charges stand in stark contrast to the provisions of this decree, which was specifically designed to ensure universal access to these vital services.
Official Policy and Challenges
Dr. Fidel Nkezabahizi, the Minister of Public Health, affirms that the free care measure for pregnant women and children under five is clearly defined. Minister Nkezabahizi acknowledges that the implementation of this policy faces several challenges. These challenges include difficulties with importing medications, which often require foreign currency, and global conflicts disrupting supply chains for essential medical provisions. These external factors significantly impede the consistent availability of necessary medical supplies within the country.
Since the beginning of 2026, collaboration with technical and financial partners, including the World Bank, has been reinforced to support the free care program. This support includes additional stocks, which are currently being shipped via the port of Dar-es-Salaam. Minister Nkezabahizi also stated that non-compliance with the referral circuit by some patients presents a challenge for the system, affecting the smooth operation of the free healthcare initiative. This non-compliance can lead to inefficiencies and increased costs within the healthcare delivery framework.
Government Response and Outlook
The chief of the sanitary district of Commune Bururi referred inquiries regarding the policy's implementation to the spokesperson for the Ministry of Public Health. Challenges faced by the program include difficulties in importing medications, which often require foreign currency. Global conflicts are also disrupting supply chains for essential medical provisions. Currently, the availability of essential medicines for the free healthcare program has reached approximately 70% of the needs planned for the year. All expected medications, key for supporting the initiative, are projected to be available by September 2026. This anticipated improvement in supply aims to alleviate the current shortages and reduce the financial burden on families in Commune Bururi and beyond.