A Scoping Review of Healthcare Delivery Challenges in Burundi: An African Perspective

Burundi's healthcare system faces substantial challenges, particularly within obstetrics and gynaecology. These exist within a wider context of resource constraints, a high disease burden, and complex socio-economic factors typical of many low-income African countries. A consolidated overview of these specific barriers is needed. This scoping review aimed to systematically map and synthesise literature on healthcare delivery challenges in Burundi, focusing on maternal and reproductive health services. Its objective was to identify key thematic barriers and evidence gaps to inform future interventions and research. The review followed established scoping review frameworks. A systematic search of multiple academic databases and grey literature sources was performed. English and French language studies were included. Two independent reviewers screened titles, abstracts, and full texts against eligibility criteria. Data were charted to capture key details and themes. The synthesis revealed several consistent themes. A critical shortage of skilled healthcare personnel, especially midwives in rural areas, was predominant. Significant infrastructure limitations, including unreliable access to essential medicines and equipment, were reported. Financial barriers for patients, notably user fees, were a major deterrent to accessing antenatal and delivery care. Healthcare delivery in Burundi’s obstetrics and gynaecology sector is constrained by interconnected human resource deficits, infrastructural weaknesses, and financial access barriers. These multifaceted challenges contribute to suboptimal health outcomes and indicate systemic vulnerabilities. Priorities include increased investment in training, deploying, and retaining skilled birth attendants. Policy reforms should develop sustainable financing to reduce out-of-pocket costs for patients. Further primary research is required to evaluate specific intervention strategies in this setting. Burundi, healthcare delivery, maternal health, reproductive health, obstetrics, gynaecology, health systems, Africa. This review provides a synthesised analysis of the documented barriers to maternal and reproductive healthcare in Burundi, clarifying priority areas for policy action and future research.