Burden of disease data help to illuminate new policy priorities in Rwanda

In Rwanda, IHME’s collaborators are using GBD data as they tackle the growing burden of non-communicable diseases (NCDs) and improve care for people living with disabilities.

Teams from the Rwandan Ministry of Health have played an important role as collaborators in the GBD enterprise for many years, contributing their expertise in identifying data sources, vetting results, and ensuring these results are accessible to decision-makers. Over this time, they have used GBD to help identify and address pressing health issues, leading to interventions to reduce the burden of indoor air pollution and increase investment in training and equipment for neonatal care.

Now, the Ministry of Health is further aligning its priorities with the changing health needs of its population. NCDs are becoming an increasingly important contributor to health loss in Rwanda, causing 35% of DALYs in 2016 compared to just 16% in 1990. Using GBD data, the Ministry was able to pinpoint some of the key drivers of this trend and take action. Based on the evidence that behavioral risk factors such as alcohol and tobacco use had a substantial impact on the development of non-communicable conditions, the Rwandan government has put in place a package of interventions aimed at reducing their use.

These have included laws on tobacco control and those governing narcotic drugs (including strong alcoholic drinks), psychotropic substances, and their precursors. Other interventions seeking to prevent NCDs have included innovative strategies for promoting exercise. For all of Rwanda’s civil servants, Friday afternoon is now dedicated to engaging in physical activity, and in the capital Kigali, the first Sunday of every month is now a popular “car-free day:” the city’s streets are closed to cars and residents are encouraged to leave their homes to go walking or jogging. 

Most recently, Rwanda has instituted a National Council of Persons with Disabilities, with the Ministry of Health highlighting the importance of providing quality services for people living with disabilities. The GBD study was a useful tool in helping decision-makers understand the scale and impact of these conditions, which also led to their incorporation into Rwanda’s latest Health Sector Strategic Plan. This emphasizes the need for a range of interventions to reduce health loss from disabilities, including improving access to health services and assistive devices, promoting education and advocacy, and developing community-based strategies for prevention, treatment, and rehabilitation. Working with GBD collaborators, the Directorate General of Planning, Monitoring and Evaluation, and Information Systems at the Ministry of Health has also drawn on GBD estimates in the process of developing  the health sector strategic plan, with injuries and disabilities among its priorities. 

Dr. Jeanne Francoise Kayibanda, an epidemiologist and GBD collaborator since 2013, has supported the Directorate General in this work. Through her faculty appointment at Harvard Medical School’s Department of Global Health and Social Medicine, she supports the Rwandan Ministry of Health in using GBD estimates for developing evidence-based health policy.

“For areas like maternal and child health and infectious diseases, Rwanda has an established system that informs the Ministry of Health,” explained Dr. Kayibanda. “Now, for example, with Rwanda’s policy on occupational safety and health, it is very important to use GBD estimates to strongly monitor its implementation”.

GBD collaborators are also continuing to help strengthen disease burden estimates for Rwanda by developing improved data collection systems across the country. Through their extensive contributions to the GBD study, collaborators at the Rwandan Ministry of Health are working to ensure that decision-makers can respond quickly and effectively to a changing landscape of population health.