Panel at Rockefeller Foundation Global Health Summit

On January 26-27 I spoke on a panel at the Rockefeller Foundation Global Health Summit in China. Below you can watch the entire panel, (my presentation on Rwanda begins at 16:00).

You can also access this video on YouTube by clicking here.

The Importance of Using Accurate Data: Case Study of Hunger in East Africa

On Saturday, 3 November, I published an op-ed in The East African responding to a recent article describing the findings of the "Global Hunger Index 2012," a European report analyzing the state of food insecurity around the world. The report's authors used extremely outdated data for Rwanda in their calculations, skewing their conclusions. My response attempts to call attention to the importance of using the latest and most accurate data in such global assessments.

http://www.theeastafrican.co.ke/OpEd/comment/Hunger+Index+used+outdated+data+for+Rwanda/-/434750/1611056/-/11hpa0p/-/index.html

Hunger Index Used Outdated Data for Rwanda

By Dr. Agnes Binagwaho

As with many international reports derived from complex and non-transparent methodologies to assess relatively straightforward challenges, the Global Hunger Index of 2012 represents an outdated and poorly designed approach to quantifying progress towards Millennium Development Goal 2. -As recently reported in The East African, the Index report ranks Rwanda behind only Burundi for food insecurity in the East African Community.

Based primarily on inputs of child mortality rates and chronic malnutrition or stunting among children under age five, the Hunger Index calculation could not possibly be using updated data for Rwanda, as the child mortality rate has declined by fully 50 per cent between 2005 and 2010 according to both our own internationally-validated Demographic and Health Surveys (DHS) and the World Health Organisation’s modelled estimates. The latest WHO figure shows that Rwanda’s child mortality rate is 54 deaths per 1,000 live births. Yet the Global Hunger Index report cites Rwanda’s child mortality as 91 deaths per 1,000 live births – using an old Unicef report from 2009 that is based on the 2008 DHS.

If child mortality has been falling so much but Rwanda’s Hunger Index has not, then malnutrition must be paradoxically skyrocketing despite increased access to all other child health interventions? But one look at DHS or WHO data shows otherwise: Chronic malnutrition among children under five years old decreased from 51 per cent to 44 per cent between 2005 and 2010. The proportion of children underweight plummeted from 18 per cent to 11 per cent over the same timeframe. But the Global Hunger Index report the 18 per cent figure from seven years ago.

How does Rwanda’s progress across broad socioeconomic indicators stack up to the assertion that its people are among the hungriest in East Africa? Fully one million Rwandans pulled themselves above the poverty line between 2005 and 2010 according to the latest Household Living Conditions Survey, and access to electricity, potable water, adequate sanitation have all improved dramatically since 2000. While Rwanda’s population has increased by nearly three million over the past decade, its Food Production Index compiled by the World Bank has increased by two-thirds over the same timeframe and climbed to the highest in East Africa. Finally, cereal yield in kilogrammes per hectare nearly doubled between 2007 and 2010, and is likewise the highest in East Africa.

While Rwanda is on track to meeting or exceeding all eight UN Millennium Goals in advance of the 2015 target, we are not resting on our laurels. We are acutely aware that still we have far to go in eradicating malnutrition and improving health outcomes, especially among children. In order to achieve our goals, however, we are obliged to develop and implement policies based on accurate data along with astute analysis.

In a country and region changing so rapidly, it is the responsibility of institutions such as the International Food Policy Research Institute, Welthungerhilfe, or Concern Worldwide to concern themselves with facts, not conjectures or models when robust and current evidence is easily accessible. If such “watchdog” agencies and the reports they produce are to serve a useful purpose (and I do believe they can when designed well and disseminated transparently), they must hold themselves to the same standards of accountability they seek from countries like Rwanda. No one more than the Ministry of Health knows that Rwanda has a long way to go until chronic malnutrition is not a massive health challenge, but it is our responsibility to base our approach on solid evidence and sharp analysis.

Recommendations based on the latest data can help public sector institutions to improve policies, strategies, and implementation of programmes to tackle challenges like malnutrition, but when they are conducted sloppily, one wonders whether the money spent on consultancies for such a document might be better invested in helping to grow food for improved nutrition of children around the region than using large amounts of overheads to create metrics that are out of date before they are even published.

Agnes Binagwaho is Rwanda’s Minister of Health.

Medical Grant Writing Training in Kigali

Group photo at the medical grant writing training in Kigali hosted by Imbuto Foundation and IAVI

Last week, I spoke at the opening ceremony of a two-day medical grant writing workshop in Kigali. To follow up, I am sharing my thoughts on the relevance and importance of such trainings.

It is essential that Rwanda own its research, results, and publications. Today, the normalcy of foreign researchers studying and publishing Africa’s own results must be tackled just as seriously as we tackle diseases. If we don’t start to document our own progress on the continent, we will inevitably allow foreigners to continue to study our population’s health and write about it without including national researchers and implementers. Certainly there are examples of non-Rwandans who have successfully partnered with Rwandan researchers on studies and publications, but this type of partnership must become the norm across the continent.

One very important way to improve regional ownership over data and results is to train our young professionals on how to write grants for medical research. A workshop held on 11-12 November 2011 hosted by the Imbuto Foundation and the International AIDS Vaccine Initiative drew young professionals from across the region for a training in medical grant writing. The forum was called, “Africa Young and Early Career Grant Writing” and was attended by Ugandans, Kenyans, Zambians and Rwandans. A strong skill-set in medical grant writing is absolutely key for winning funds for research and building a career in clinical medicine and public health. There is no time like now to start training our young health professionals in the region. We need regional ownership of research and data, and in order to do so, we need diligent young people who are well-trained in the science and art of medical grant-writing.

Click here to read more about this initiative on The New Times.