Assess
Geo-mapping tools
In this section you will learn:
- What geo-mapping is
- The benefits of geo-mapping
- Three possible approaches for a geo-mapping survey
- Four essential phases in the geo-mapping process
- How geo-mapping enabled the Ugandan Government to make clear decisions on its healthcare service delivery models
What is geo-mapping?
Geo-mapping assists in identifying areas where outsourcing could play a role to support supply chain functions and prioritise the allocation of resources in the overall health system. Geo-mapping identifies and locates key health sites for improved supply visualisation and decision–making. Spatial data mapping can be used as an intrinsic tool to improve the in-country distribution of medicines to patients and facilities.
The field of geo-mapping has many terms that you might not be familiar with. Two key terms that you should know are 'geo-mapping survey' and 'Geographic Information System' (GIS). A geo-mapping survey is the collation of information regarding the spatial distribution of health facilities and other key sites. GIS is a software tool that can be used to analyse, manage, and view geographical data. GIS can enable decision making by overlaying relevant metrics, such as the spread of the burden of disease and spatial distribution of health facilities, to enable strategic decision making by visually presenting data.
Using GIS gives the ministry of health the ability to accurately geo-code and give coordinates for health facilities with a low churn rate. It also addresses the major challenge for less formal countries and geographies where road infrastructure is limited or there is a lack of coordinates. Finally, GIS creates the ability to cross-leverage existing databases (e.g. GIS data; Health Department data) within Government which can help provide a more complete picture of health service availability.
The benefits of utilising a GIS include:
- Improved supply chain visualisation and decision making through the availability of detailed insights
- Identification of gaps or functions where outsourcing could be beneficial
- Reduced costs and increased efficiencies particularly in logistics planning, fleet management and maintenance schedules
- Improved record-keeping through the registration of key sites and their important data (location, facility type etc.)
Possible approaches for a geo-mapping survey
There are three possible approaches for a geo-mapping survey.
1. Perform in-house The first option is to perform the entire geo-mapping exercise with public sector parties with no involvement from outsourcing partners. This approach is used when the experience and expertise reside in-house. For example, when the public sector has a well-capacitated GIS Department to perform the full geo-mapping exercise including high levels of GPS and facility/database accuracy.
2. Partner with external partners
In the second option, the ministry of health performs parts of the geo-mapping exercise with public sector resources. Other roles and functions of the geo-mapping exercise are outsourced. The types of functions that might be outsourced include the development of the survey guidelines or the contracting of a technical advisor from the private sector. Ministries of health can apply this approach when wanting to build in-house capability and sustainability of the database accuracy.
3. Outsource the geo-mapping The final option is to contract a third-party entity to perform the entire geo-mapping exercises in a fully outsourced arrangement with no to limited involvement with public sector entities. This approach can be used for a once-off initiative that does not require capability development in the ministry of health.
Essential phases in the geo-mapping process
Regardless of which approach you take for the geo-mapping process (in-house, partnering or outsourcing), there are four phases that the process will follow:
Phase 1:
Develop survey tools
This phase includes:
- Establishing survey objectives, develop the brief and work-plan
- Database reviews (GIS, health facilities, patients)
- Data collection, data security and quality checks, record and database uploads
- Customised app development; build the survey questionnaire
- Facility level identifiers e.g. hospital, clinic
- Ownership identifiers e.g. government / private
- Basic services identifiers e.g. supply of water, electricity, mobile reception, internet, number of clinicians; road type
- Photo at facility; GIS coordinates
Phase 2:
Perform training and surveying
This phase includes:
Training
- Initiate training workshop with ministry of health field team supervisors
- Training materials, videos for supervisors, field teams
- Ministry of health workers trained in electronic data collection
In-field survey
- Conduct an in-field survey per region
- Daily quality control and link to master facility list
- Quality control feedback and capture of any outstanding facilities
- Region report and sign-off by geo-mapping supervisors
Phased 3:
Data capture and quality control
This phase includes:
- Data captured into the central system and downloaded from a server daily
- Data checked for duplicates, blanks, incorrect survey entries
- Coordinates checked to ensure accuracy within a 10-metre range
- Data linked back to master lists to ensure all facilities and pharmacies are covered
- Photo of facility taken to ensure field teams visited correct facility and facility names / contact details are correct
Phase 4:
Data analysis and reporting
This phase includes:
- GIS data to inform gaps and opportunities e.g. route optimisation, healthcare service delivery model re-design, depot, regional hubs, warehouse decision-making
- Identify supply chain network capabilities – such as remote or underserved regions with high population density.
- Geo-mapping identification of areas where outsourcing could have an impact to improve and/or strengthen the healthcare supply chain
Example of the geo-mapping process
The following example will illustrate how the geo-mapping process can come together to help inform decisions about healthcare service delivery.
