Innovative use GIS for target population estimation

[Dr. Khalid Abubakar]

Using GIS estimated target population and maps in developing REW microplans

Background 

REW (Reaching Every Ward) as a strategy of providing regular, equitable, effective, quality, affordable and sustainable RI activities by reaching child in every ward, in order to improve immunization coverage.

The quality of routine immunization (RI) depends basically on the successful implementation of the six (6) major components of REW. Planning and management of resource, one of the component of REW serves as the bedrock for the successful implementation of RI. Good Microplan entails assignment of settlements in catchment area for each health facility, ensure all settlements are planned to covered irrespective of its distance or accessibility (e.g. outreach and mobile sites) are paramount. It is equally important to establish realistic target populations for every RI offering HF in every ward and LGA, which was estimated through the GIS technique. 

Without these two basic requirements, program planning including REW microplanning, distribution of services providers, distribution of vaccine-medicine-logistics, and assessment of program performance would be difficult. Allocation of settlements to health facilities is the core foundation for effective PHC program planning and management.   

 REW microplan exercise was conducted in other to dis-aggregate health facility catchment areas with the guide of GIS maps and estimated GIS target population was validated by the community. 

Initial challenges were taken in consideration for the exercise to provide guide in planning and possibly solve some problems like high administrative State/ LGAs coverages due to denominator challenge, settlements missed in HFs catchment areas for RI services and waste of resources in particular Funds for outreach and other logistics etc

Justification for the exercise

The main objectives remain to addressed RI challenges directly or indirectly related to poor REW microplanning, others

1. Validate the estimated GIS target population of children age < 1 year in each settlement/ward/ LGA through engagement of the community

2. Used of polio master list of settlement (MLOS) to update the list of settlements and their locations on the GIS maps provided

3. Demarcation of specific HFs catchment settlements on the GIS map/ HFs catchment area on maps

4. Development realistic Microplan in each Health Facility after TP validation 

Participants involved all the immunization stakeholders as well as members of the community include; Village Head / Ward head, WDCs, other community resource persons (TBAs, TB), and HF In-charges were invited to the ward headquarters for meeting to discussed 

 Assigned team discussed with ward representatives and update the master list of ward settlements, target population and number of household, to come up with justifiable distance for proper RI strategy.

 Printed ward map was compared with the updated master list of ward settlements for their relative position and health facility catchment area was updated to ensure no settlement left uncovered

 The team documented the GIS estimated target population as agreed with the communities.

 The service providers develop microplans and catchment areas were demarcated on the map for each facility

 All participants endorsed on the updated master list of ward settlements.                                                  

1. Tools Use include; Printed GIS ward map, Copies of Polio Master List of Settlements (MLOS), GIS estimated target population. Other materials include, cardboard paper, pencils, microplan templates etc.                        

Findings 

There was significant reduction in the proportion of outreach sessions by 40% after the update of the REW microplan estimated by GIS. It was due to the fact that the standard REW guideline was used to allocate number of session required by HFs based on the distance and there was clustering of outreached settlement. 

It was opportunity to justify allocation of resources for service delivery and logistics, reduction of vaccine wastage and possible obtained quality data for decision making, planning and monitoring/evaluation.

1. Missed settlement identified by community were updated on the maps. 

2. Duplication of some settlement occasionally using different name for same settlement were corrected.

3. Some settlements were merged however dis-aggregated 

4. Sessions plan were updated and appropriate strategy was assigned for settlement, while some HFs observed no justification for conducting outreach sessions 

Challenges

1. List of settlements from neighboring wards were observed to appear in adjacent wards.

2. Some boarder settlements were observed to benefit services from neighboring wards due to proximity, difficulty in harmonizing the data and logistics for RI service.

3. Settlements exist not in any HF catchment area” No man’s land”

4. Resources needed for the conduct of exercise was quite high need donor support.

Innovation: - Currently microplans for measles campaign 2017 in Nigeria, GIS was used for estimation target population and team allocated for the conduct of exercise.

    

[mustafa mahmud]

Dear Colleagues,

Thank you Khalid for sharing. 

In addition to this, there is also a feature on the vaccination tracking system website that allows user to generate maps of desired, wards, LGAs etc and overlay it with chosen attributes such as HFs, mosques, churches, water points etc. In addition you can create a catchment area such 2km/5km circumference around the chosen location and estimate its population. This is of great significance in public health as it allows you to undertake micro-planning for interventions at very short notices. It is also of great application for evaluations in surveys. 

Dr Mahmud

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[Dr. Khalid Abubakar]

Thanks doc. Mustapha

Upcourse VTS is very good especially during IPDs implementation which monitored teams performance through real time tracking of coverage and reduce chances of missing settlement in the areas where tracking was conducted. 

We have issues with tracking of population movement, especially seasonal migrant ie nomadic. However the  quality of immunization campaign significantly improved through GIS.

Thanks alot

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