Reaching an AIDS-Free Generation (RAFG) in Burundi


In Burundi, University Research Co. (URC) is working as subcontract to FHI 360, under the Reaching an AIDS-Free Generation (RAFG) Activity. In the implementation of the RAFG Project, URC has been selected to implement Quality Improvement (QI) activities and ensure they are integrated into the overall program in all the targeted provinces.


The Challenge

Burundi has achieved incredible progress in the fight against HIV/AIDS. Since 2010, new HIV infections and AIDS-related deaths have been halved, according to UNAIDS. However, despite progress, Burundi remains one of the poorest countries in the world and non-health factors.



To scale up antiretroviral therapy (ART) services for people living with HIV (PLHIV). By using an integrated, community-based approach in high-prevalence provinces, the project can contribute towards the Government of Burundi’s goal to achieve epidemic control nationally. To achieve the UNAIDS 90-90-90 goals in Burundi, three intermediate results are outlined:

  • Identify HIV-positive men, women, and children through high quality, targeted HTS and link to ART services;
  • Increase ART coverage in men, women, and children living with HIV; and
  • Ensure HIV-positive men, women, and children on ART are virally suppressed.

The FHI 360-led consortium is using the science of QI to strengthen the service delivery system at the facility and community levels. QI models are used to address the systemic issues that affect the delivery of HIV services so that the system of care for HIV patients achieves its expected performance along the 90-90-90 goals.

The RAFG activity is supporting Health District teams to be able to frame the Quality Improvement Teams (QITs) in order to perform Continuous Quality Improvement (CQI) system. Health district teams help QITs to define CQI; identify a conceptual framework to consider when implementing CQI techniques in a practice setting; and explore tools, techniques, and strategies that health facilities use to guide CQI initiatives.

In addition, the RAFG Activity provides supports at the National Program level to develop an adequate and functional QM/QI system for care and treatment services. From October 1, 2018, RAFG Activity is being implemented in Kayanza, Kirundo and Gitega provinces, in addition to the previous three provinces, namely Bujumbura Mairie, Bujumbura and Ngozi where activities were implemented since the beginning of the project (January 2018).



Results as of Q1 FY19

  • 123,845 individuals tested for HIV and 1,336 diagnosed HIV-positive, with 1.1% of yield.
  • Of the 1,336 diagnosed HIV positive, 1,274 (95.4%) are newly linked on ART treatment.
  • A total of 39,505 PLHIV are currently on ART and among them, 24% PLHIV who were eligible are tested for viral load with 89.2% of viral load suppression.


2018 to 2022
The US President's Emergency Plan for AIDS Relief (PEPFAR)
FHI 360
Regions/ Countries