Burundi's economy has been battered by the "calamitous effect" of a three-year political crisis which has wiped out modest gains that had been made, an International Crisis Group (ICG) report said on Friday.
The east African nation plunged into crisis in April 2015 when President Pierre Nkurunziza sought a third term in office which he went on to win, sparking violence which left at least 1 200 dead and over 400 000 displaced.
"In the wake of this political and security crisis, the country's economy has shrunk at an alarming rate and socio-economic progress made after the end of the civil war in the 2000s has been derailed," said the report.
Annual economic growth went from an average of 4.2% between 2004 and 2014, to a contraction of 3.9% in 2015 and a contraction of 0.6% in 2016.
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"People across society are paying the price. Farmers and traders are struggling because internal demand for their products has declined; civil servants' purchasing power has fallen; and shopkeepers report giving ever more customers credit," said the report.
It said that many Burundians sought second jobs or engaged in petty corruption to get by.
"A decade of progress in health and education has been swept away. Many doctors have left the country. Teachers are often paid in arrears. University education is under threat as student grants are cut."
In 2017 Burundi counted only 500 doctors for a population of over 11 million, with around 100 having left the country after the crisis.
Food and fuel shortages are rife, foreign currency reserves are low and a flourishing black market has driven up prices - with the black market exchange rate even published in newspapers.
The government "has introduced new taxes and obligatory public 'contributions', forcing civil servants and ordinary Burundians to donate extra money to state coffers."
The ICG urged the EU and its member states - who suspended direct aid to the government - to increase assistance to the population by strengthening the capacity of NGOs.