Rwanda Triangulation II Project

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Investigator: Stephanie V. Taché, MD, MPH
Sponsor: Futures Group International

Location(s): Rwanda

Description

"Triangulation" aims to synthesize data from multiple sources to strengthen the understanding of complex health issues and help make evidence-based public health decisions. The methodology of triangulation involves overlapping data on prevalence, risk behaviors, cofactors, and programmatic response for a specific subpopulation or geographic area of concern. Triangulation was applied to data from Rwanda to answer two over-arching questions: 
 
What are the differences in HIV prevalence among different population groups over time? What are the potential causes for these differences?  Are there gaps in HIV/AIDS programmatic coverage according to prevalence and/or need? 
 
The Rwanda Triangulation Project was carried out from December 2007 to September 2008. The project was launched with a stakeholder meeting to identify relevant questions. These questions were prioritized, data sources were identified, and a task force was created. Four months were devoted to compiling and analyzing data. Over 100 independent sources of information on the HIV epidemic in Rwanda were found, including demographic and health surveys, HIV behavioral surveillance data, quantitative and qualitative research studies, and programmatic reports. A final workshop was held in Kigali in September 2008 to conduct training on the methods of triangulation, interpret the data, and make recommendations. 
 
Participants at the final triangulation workshop in September 2008 examined a multitude of HIV/AIDS-related indicators at the national, new province, and former province levels to understand epidemic patterns by geography. Data from sentinel surveillance at antenatal clinics (ANCs) were used as the basic gauge of HIV prevalence trends, while the 2005 Demographic and Health Survey (DHS) was used to look at magnitude of HIV prevalence. Using the ANC data, the DHS data, and potentially corroborative data from other sources, participants were charged with identifying regional (new province) epidemic patterns. Participants categorized the epidemic by ―concerning and ―reassuring using the national DHS indicators as a basis for comparison.