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Comparative Study
. 2011 Feb 25;10:15.
doi: 10.1186/1476-072X-10-15.

Free and Simple GIS as Appropriate for Health Mapping in a Low Resource Setting: A Case Study in Eastern Indonesia

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Free PMC article
Comparative Study

Free and Simple GIS as Appropriate for Health Mapping in a Low Resource Setting: A Case Study in Eastern Indonesia

Rohan P Fisher et al. Int J Health Geogr. .
Free PMC article

Abstract

Background: Despite the demonstrated utility of GIS for health applications, there are perceived problems in low resource settings: GIS software can be expensive and complex; input data are often of low quality. This study aimed to test the appropriateness of new, inexpensive and simple GIS tools in poorly resourced areas of a developing country. GIS applications were trialled in pilot studies based on mapping of health resources and health indicators at the clinic and district level in the predominantly rural province of Nusa Tenggara Timur in eastern Indonesia. The pilot applications were (i) rapid field collection of health infrastructure data using a GPS enabled PDA, (ii) mapping health indicator data using open source GIS software, and (iii) service availability mapping using a free modelling tool.

Results: Through contextualised training, district and clinic staff acquired skills in spatial analysis and visualisation and, six months after the pilot studies, they were using these skills for advocacy in the planning process, to inform the allocation of some health resources, and to evaluate some public health initiatives.

Conclusions: We demonstrated that GIS can be a useful and inexpensive tool for the decentralisation of health data analysis to low resource settings through the use of free and simple software, locally relevant training materials and by providing data collection tools to ensure data reliability.

Figures

Figure 1
Figure 1
Schematic representation of the flow of health data in eastern Indonesia. Currently (a), district staff send health data to the provincial and national levels to inform allocation of resources back to the districts. Potentially (b), district health staff could develop the capacity to analyse and interpret data to (c) inform district level resource allocation and to (d) advocate for appropriate resource allocation from the national level.
Figure 2
Figure 2
Location of study districts (Ngada, Nagekeo, Timor Tengah Selatan (South Central Timor, TTS) in the eastern Indonesian province of Nusa Tenggara Timur. The provincial capital, is Kupang, in West Timor.
Figure 3
Figure 3
System of data input and analysis: new reliable data collected using Cybertracker, new or existing data mapped and analysed in Open Jump, service availability modelling conducted in ArcView using the AccessMod© extension.
Figure 4
Figure 4
Maps produced at a village clinic in TTS, West Timor. (a) Hand-shaded map of number of malaria cases in the villages within the subdistrict of Kie, made before training and showing a pre-existing understanding of the value of health mapping. (b) Map, made by clinic staff after training, showing the number of malaria cases per village over a ten year period (1997-2007) from clinic data.
Figure 5
Figure 5
Estimated travel time of up to two hours around the clinics which provide basic emergency obstetric care and the hospital providing comprehensive emergency care in Ngada district, Flores.
Figure 6
Figure 6
The locations of pregnant women, health facilities and major roads in one subdistrict.

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