Dr Rose

Interview: AFIDEP’s Dr. Rose Oronje on the power of evidence for Africa’s development

(Last Updated On: 14 September 2023)

Entebbe I Shortly after day one of the ongoing Africa Evidence Network 2023 Conference taking place in Uganda ended, TND News had a conversation with Dr Rose Oronje, Director of Public Policy & Knowledge Translation & Head of Kenya Office at African Institute for Development Policy (AFIDEP).

Dr Oronje has led three of her colleagues at the Institute and they are among the over 300 delegates across at least 10 countries in Africa in Uganda for the three-day event.

The publication and Dr Rose talked about the roles of AFIDEP, the conference and its relevance, the future and more. Read the full interview below.

First, tell our audience what AFIDEP is

AFIDEP was set up in 2010 to support governments in using data and evidence in decision-making on a day-to-day basis. Governments were using evidence but they were using them once in a while: once every five years or ten years when they were making their long-term strategies. But AFIDEP believes that for every decision they make on a day-to-day basis, every three months, and quarterly decisions, they need to be looking at data and evidence.

We believe in that because when you use data and evidence you are clear on where to invest your limited resources, you are clear on which interventions will work and which ones will not work, and you are not making decisions in the dark. Evidence helps you make better decisions and for us, the argument is that: ‘In a setting in Africa where we have very limited resources, our national cake or budget is also very small, that is a place where you have to use evidence because you are better placed to know where to put your resources to get more returns on it.’ That is why AFIDEP was formed.

What has it been like working with different governments on the continent?

We have done a lot of work with different governments across the region. Actually, we are looking back and realise we have more than 25 government institutions in Africa. Much of what we have done, is just to provide evidence. We have done a lot of modelling, helping African governments look at their populations and model how they will look for instance in 2050; what it means, and what investments they need to make for those populations to drive the economic growth. So, we provide evidence directly like that but we also look at the longer term.

We are not going to be providing evidence every day and the government institutions need to have their own capacities, they need to have their own investments to be able to provide the evidence they need. So, we have done capacity building in terms of training and mentorship of governments’ technocrats in evidence generation, synthesis and modelling; we have supported the development of tools (..we realized that to make something a norm, sometimes you even need tools in decision-making systems) that enable you to look at the evidence and require you to look at the evidence.

Also read: Africa Evidence Network I 2023 Conference: What Ugandan Minister Beatrice Akori said before the official start

So, we have supported the development of evidence-use checklists, and use guidelines and governments have now placed in their routine processes to promote evidence use. We have also challenged them to invest more in evidence. One of the things we realized in Africa is actually we do not invest in research that much. We have research institutions but we let external people invest in giving grants to researchers to research and pay well. 

Part of our work is advocacy. If you are really going to make better policies based on research and evidence, you need to invest in it. We have also challenged them to put in place the structures, the divisions, and the departments to drive the use of data in decision-making. For instance, in some places, these structures exist, and in some places they don’t.

We have found places where these structures exist but often they have no budgets and no relevant staff. For instance, the Kenyan Ministry of Health had a research division with three people, medical doctors without any training in the understanding of data use and all that. What we did as AFIDEP was starting to work with them in 2013 to support developing a clear strategy and division. 

What should that division be doing at the Ministry of Health in terms of promoting their evidence, providing guidelines, and even just championing the use of evidence in decision-making?

In some places, we found there are no structures. For instance, we did some work in Nigeria – the Lagos State, the Federal Ministry of Environment and they got so interested in this work that they set up knowledge translation units for them to have the structures to help them be able to synthesize data in decision making. So, that is part of what we have done with the governments in Africa. Of course, we have only scratched the surface, there is a lot more that needs to be done.

What do you think is the impact of the Evidence Conference happening here this year?

Just some history: this conference started in 2014. It happens after every two years and all the conferences have been held in South Africa. This is the first time it is being held out of South Africa because a local institution like ACRES (The Centre for Rapid Evidence Synthesis) was ready to host this conference. The impact of this conference is, I think two things: one of them is raising the value of data and evidence in decision-making because we know that decision making especially in governments or Parliaments is a political process and sometimes data is put aside and we make decision driven by ideology-party interest, community interest or religious interest so this conference is raising the value of evidence as a central driver of decision making in Africa.

Also read: Scientists call for investment in climate change and health nexus research in Africa

Secondly, I think it is expanding the number of champions. You know, we are talking about evidence and data. As I said on the panel, 20 years ago I was probably the only one saying, ‘You know we need to work with the government, we need to do this.’ Right now, if I go back to that institution (I still have a contact there), they have a very big department that has more than 15 staff who are promoting evidence use and supporting serious use of evidence. The value of this is to expand the champions. You don’t need to be working in research, AFIDEP to promote the use of data – we want people in media like yourself, Civil Societies, people in Universities, and people in governments to be champions of data and evidence – that is the value of this conference. 

Do we have evidence crisis on the Continent?

[Dr Rose pauses briefly] I wouldn’t say there is a crisis. I would say that there is an opportunity for Africa to make evidence matter for Africans. Whenever you think about development (global development), in Africa, we are always down there, like our indicators are really bad. You look at indicators of women who die giving birth, very high compared to other regions of the world.

You look at the indicators of the number of children who die before 5 years; again Africa has very huge numbers compared to everybody else in the world. And so, there isn’t an evidence crisis but there is an opportunity for Africa to focus on using data to track our performance, to hold our leaders to account because you know we put in budgets. 

Sometimes our budgets don’t produce the results we want and so, evidence gives us an opportunity to be able to track our performance regularly. How we reduce maternal death – evidence will help us do that but important, if you are not doing that, evidence will also help us know why are we not saving women’s lives, yeah. Evidence will also help us know ‘are our budget in investments producing the results we want’? Because even in our country we have a very small budget, not even enough to meet our needs. 

Issues around corruption. Corruption is persistent on the continent. Evidence is the solution we’ll make citizens understand how much is the government putting in, how is this being used, and tracking that – they will be able to hold our leaders to account and for them to track that they need data, they need evidence. They need to be aware of what is going on within development, how much budget, what are the strategies… so I wouldn’t say there is ‘an evidence crisis’ – I think the crisis we have on the continent is development, we are not making progress. And if you look at the SDGs, we are actually off track. So, if we continue the way we are going, by 2030 we may not achieve most of the Goals. 

I was actually looking at some of the tables the other day. Most African countries are off track, some of them by even 40, 60 per cent off track to meeting our Goals. Goal to reduce poverty, our Goal in enhancing access to quality health services, Goal in getting kids in school – those are basic things but behind our targets. And so, the crisis we have on the continent is development, is having leaders who want to drive development.

Evidence and data are an opportunity for Africans, citizens, and people who sit in communities and go to government facilities to get health services, it is an opportunity for them to understand: that if I go into a health centre and there are no medical supplies they will be told to go and buy themselves. I would say there is an opportunity for evidence to drive development but we need more people, more citizens; CSOs, we need everyone to be evidence champions.

Would you blame corruption on the slow development of the continent?

Oh, any time. Because you know sometimes when you look at (and maybe it will vary from context to context), as I talk here now to speak about corruption I will speak as Kenya, a system where so much corruption at all levels. At the Ward level, County level, the National level and when you look at the amount of money they lost through corruption, some of those monies are monies if they put in the health system would be able to provide free maternities, free services to all those who can’t afford it.

For instance, right now Kenya government is working to introduce a social health insurance scheme that is mandatory so that everyone has access to quality health care when they need it without having to spend money. Now, the monies we lose through corruption (and I’m sorry I don’t have numbers) but the monies we lose through corruption in the country, if you look at it will be able to ensure that every Kenyan has insurance paid for by the government, not me getting into my pocket because not all of us can get money from our salaries to pay. 

If you look at our economy, 80 per cent is an informal economy, people are selling vegetables. Do they have money to contribute to the health insurance they want? And so if we can address corruption, and reduce the monies being lost we can actually have the government investing in health insurance scheme for all citizens without citizens, particularly the poor without having them look for money to put in the insurance scheme and they would have access to quality health services.

So, I think corruption remains a big deal on the continent. As long as we are not being put right in fighting corruption, there is a problem and I believe data can support citizens to fight corruption because citizens elect their leaders.

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