Emelda Okiro

An unexpected email changed the course of Emelda Okiro’s career.

She was working as a research fellow at the KEMRI-Wellcome Trust Programme in Kenya, assessing changes in hospitalizations because of malaria related to changes in intervention coverage in east and southern Africa. However, she soon realized that studying the effect of interventions across countries and regions by using only one source of data was not optimal, and that country-level estimates masked many differences occurring at the subnational level.

“Success of an intervention in one site doesn’t mean that intervention will achieve the same level of impact in another site,” Emelda says. “It’s very important for policymakers to identify subnational differences in morbidity and mortality so that they can strategically reprioritize the approved malaria control interventions according to these differences in order to target resources toward achieving the highest impact possible.”

This research experience led her to understand the importance of good small area estimation methods, and Emelda knew she needed to learn the best methods to implement these types of estimations in her work. Her mentor emailed her about IHME’s Post-Graduate Fellowship. As Emelda explains, “I needed to learn about small area estimation, and IHME is the best place to do that.”

At IHME, Emelda is working with the Demographics: Mortality and Population research team, performing small area estimation to define child mortality estimates at the district level. She’s working on the Access, Bottlenecks, Costs, and Equity (ABCE) project, a multicountry project designed to provide quality evidence for improving the equity and cost effectiveness of health systems and to examine the disparities in access to health care.

According to Emelda, “The more data you have, the better.” Because not everyone in a population receives care from a hospital, hospital data on morbidity and mortality is only part of the whole picture. The research team uses data from health facilities, national country surveys, and censuses to determine what the differences in care are, where bottlenecks in health systems lie, and how policymakers can best intervene to improve the health of a population.

Emelda’s component of the ABCE project is to determine the inequities in child mortality and to understand and quantify the underlying trends and patterns. “If you start seeing higher rates of child mortality in one area, you ask yourself, what is it about this place?” Emelda explains. “Using our estimations of mortality, in conjunction with data from health facilities and country surveys, we can put together a consistent story.”

After her fellowship at IHME, Emelda ultimately wants to be involved in work that influences policy by combining research, teaching, and advocacy. “A doctor can help one person at a time, but a researcher can help entire communities. And research output is important, but policymakers and the general public need to use the data researchers produce to improve population health. It is only then that we can make a real difference.”

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