Background

Health system maps provide an overview of the geography of the health system and the availability of health services. Access to healthcare is a non-negotiable requirement for human well-being. Quantifying access to healthcare globally is challenging owing to the lack of a comprehensive database of health facilities. 1 Improving the life conditions of people living in disadvantaged communities in low- and middle-income countries is one of the main goals of humanitarian work. One of the key challenges for this work however is the lack of accurate and up-to-date spatial data about urban areas and vulnerable communities that lack basic services. Where humanitarian Non-Governmental Organizations (NGOs) have access to these data sources, there is limited capacity to make sense of this data when planning, delivering, monitoring, and evaluating humanitarian interventions, posing huge limitations on the effectiveness and impact of humanitarian work. 2 A key lesson from the global response to the COVID-19 pandemic shows that global crises response and preparedness requires location-related information on people and resources as well as information sharing across stakeholders. 3

A workshop on making sense of humanitarian geospatial data to improve the impact of humanitarian interventions on health and wellbeing was convened in September 2018 by the Centre for Interdisciplinary Methodologies (CIM) of Warwick University and involved stakeholders from Médecins Sans Frontières (MSF), Humanitarian OpenStreetMap Team (HOT), the Bangladesh Humanitarian OpenStreetMap Operations Team (BHOOT), The Global Healthsites mapping project and the Institute of Geography at Heidelberg University. 2 Some of the key issues raised included the absence of official data on boundaries for areas or populations being served, with most of the existing maps used by humanitarian and health actors proven to have noticeable mistakes. Different health organizations use their own maps which contain discrepancies. 4 Additionally, there is no consistency of data across different health and humanitarian actors, resulting in duplication of efforts since the data is re- established by each NGO. A lot of countries do not have official lists of health facilities and villages with no reliable data for moving populations (nomadic people or refugees/internally displaced populations). One other challenge identified was the need to streamline data collection and management locally and in a format that could be shared on a global database. Likewise, the group discussed the essence of collecting and analysing metadata on trusted users of such databases to ensure quality and consistency of data input. Furthermore, the importance of creating an interface between academic and humanitarian communities who are working with and creating data was emphasized. 2,5 Following this workshop, a health catchment area working group was established to work towards establishing a centralized, operational health catchment are spatial database to be used by stakeholders in the health and humanitarian sectors.

The visualization created by mapping health zones/boundaries is important for communicating the reality on the ground to all levels of the health hierarchy and international partners who do not know the country or terrain. Such maps have proven useful in support of vaccination strategies, outbreak response, to track the progress of an epidemic and to make more accurate and swift decisions in response. Additionally, these maps have also been used to guide a micro-census to predict the number of people living in different settlements and to estimate the total population in regions which have not conducted a formal census in recent years.

“In [DRC] which hasn’t had a formal census since 1984, all population figures are estimates based on a 3 percent growth rate. If a village has say 500 kids and your estimate is 100, vaccinating 100 kids does not represent a 100% vaccination coverage. Alternatively, if your estimate is 400 kids when in reality there are only 200 kids, half the doses sent to the village will be wasted and the records will indicate a 50% vaccination coverage.”

Source: Most Maps of the New Ebola Outbreak are Wrong https://www.theatlantic.com/health/archive/2018/05/most-maps-of-the-new-ebola-outbreak-are-wrong/560777/