Access to health care through community-based insurance

Program start 2021
Impacted population 3000

Since October 2021, FXB International has been promoting the TUVUZANYE community health insurance in Burundi, which translates to “Let’s take care of each other”. This initiative aims to improve access to health care services for communities in rural Bujumbura province.


The national social protection strategy recommends the promotion of interventions that contribute to ensuring food security, health care and decent incomes for all, as well as strengthened risk management. The government relies on the initiatives of actors in the development of the insurance health movement through the “sub-contractor” principle advocated by the implementation strategy of the national social protection policy. However, the latter are still performing poorly, particularly in terms of coverage rates.

The Burundian government also promotes a system reserved for the vulnerable population, the Health Insurance Card (CAM). However, for many years, this system has been dysfunctional and does not provide good services to its members, particularly because it is underfunded by the authorities. 

Thus, aware of the extent of the damage to the resources of vulnerable households caused by uninsured health care expenses and in an attempt to contribute to the national response in the fight against this challenge, FXB in Burundi has promoted the creation of a community health insurance in the province of rural Bujumbura.

Our action

The overall objective of the project is to contribute to the improvement of the health status of members of the targeted communities. Specifically, the project aims to improve access to health care services for vulnerable communities in Bujumbura rual.

A community health insurance is an association of individuals with free membership and a nonprofit purpose, whose basis of operation is solidarity among members. TUVUZANYE insurance is based on a model managed by and for the beneficiary communities through their representatives.

During this first year of implementation, it is expected that 500 families will join the mutual health insurance and benefit from the services of partner health care providers. Depending on the health facilities providing the care, the mutual health insurance covers between 50% and 80% of the costs of the services. The annual contribution per household is 25,000 FBU, or about 12 USD. 

The initialization of the mutual system requires a transition period during which FXB provides financial and technical support. 

Program impact

After 4 years of effective implementation of the mutual health insurance in the targeted communities, it is expected that more than 1,000 households will join the mutual movement, which will be enough to cover the health costs and costs inherent to the management of the mutual insurance.


FXB facilitates the population to have access to health care. The opening of the Tuvuzanye mutual insurance company is part of this process. This structure will benefit not only the population of Mutimbuzi, but also that of neighboring communes.

Gisèle Ndereyimana, director of FXB Burundi