Local use of geographic information systems to improve data utilisation and health services: mapping caesarean section coverage in rural Rwanda

Abstract

Abstractobjectives To show the utility of combining routinely collected data with geographic location using a Geographic Information System (GIS) in order to facilitate a data-driven approach to identifying potential gaps in access to emergency obstetric care within a rural Rwandan health district.methods Total expected births in 2009 at sub-district levels were estimated using community health worker collected population data. Clinical data were extracted from birth registries at eight health centres (HCs) and the district hospital (DH). C-section rates as a proportion of total expected births were mapped by cell. Peri-partum foetal mortality rates per facility-based births, as well as the rate of uterine rupture as an indication for C-section, were compared between areas of low and high C-section rates.results The lowest C-section rates were found in the more remote part of the hospital catchment area. The sector with significantly lower C-section rates had significantly higher facility-based peripartum foetal mortality and incidence of uterine rupture than the sector with the highest C-section rates (P < 0.034).conclusions This simple approach for geographic monitoring and evaluation leveraging existing health service and GIS data facilitated evidence-based decision making and represents a feasible approach to further strengthen local data-driven decisions for resource allocation and quality improvement.keywords geographic information systems, maternal mortality, regional health planning, access to health care, Rwanda

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

“…In recent years there has been a marked increase in the number of studies drawing on geospatial techniques to either map health indicators or examine geographical access to services (e.g. [7–9]). The growing availability of georeferenced information available through large scale surveys such as the DHS provide further opportunities to use these methods in low and middle income countries to guide policy and practice.…”

Provider Perspectives Regarding the Health Care Needs of a Key Population: HIV-infected Prisoners After Incarceration

“…Community health worker and peer educator programs, for example, have proven effective in alleviating primary care shortages and assisting patients with care for diabetes, cardiovascular disease, and maternal health and child care (Shah, Kaselitz, & Heisler, 2013; Sudhof et al, 2013; Thomson et al, 2014). Other innovative approaches might include models of telemedicine, which are being piloted to improve access to provider training in underserved areas and as a tool to provide care to individuals in rural areas and in prisons (Fortney et al, 2013).…”

Investigating Barriers to Tuberculosis Evaluation in Uganda Using Geographic Information Systems

“…Geographic information systems (GIS) methods allow investigators to create digital representations of the landscape to enable estimation of the distance that patients travel, a technique that is complementary to information obtained from patient reports and more scalable for data collection on large populations. [9][10][11][12][13] In addition, newer techniques can be used to estimate travel time, which may be preferred for analyses of access to care because travel time varies among regions based on geography and mode of transportation. [12][13][14][15][16][17] Therefore, in this study, we used GIS to examine the relationship between the distance to care and patient travel time and the likelihood of completing TB evaluation in a multicenter study in rural Uganda.…”