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methodologies to assess relatively straightforward challenges, the Global Hunger Index of 2012 represents an outdated and poorly designed approach to quantifying progress towards Millennium Development Goal 2.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 EastAfrican, 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.