INTEGRATING GEOGRAPHICAL INFORMATION MAPPING WITHIN PUBLIC HEALTH INFORMATION SYSTEMS
The case of eRHMIS in Sri Lanka
T.C Vithanage
PGIM/ m34391
INTRODUCTION
INTRODUCTION
Geographic Information System (GIS) is a system that creates, manages, analyses and presents all types of spatial and geographical data, enabling integration of location data with descriptive information.
Advantages of GIS
- Being able to map and visualize spatial location of real-world features.
- Mapping quantities and densities of multiple indicators to assess the quantitative relationship between multiple special data.
- To find nearby areas and compare indicators to assess the significance according to their geographical distribution.
- To predict conditions according to the geographical distribution.
Electronic Reproductive Health Management Information System (eRHMIS)
- eRHMIS is a DHIS2 based Health Information Management System developed and implemented to manage the data from Reproductive,Maternal, New-born, Child, Adolescent and Youth Health (RMNCAYH) programmes in Sri Lanka since 2017.
- DHIS2 is an open source, web- based platform commonly used as a health management information system (HMIS).
Need for a PHM area Map
- Data collected by PHM areas are still not incorporated in a geographic information map as a service delivery map in eRHMIS.
- To analysing and summarization of grass root level data in a spatial data distribution.
- To identify the problematic PHM areas and conduct prompt action directly to the specific targeted PHM areas.
- In an epidamic situation to anticipating epidemiological trends and making valuable decisions to get control of the outcome.
- To help in planning and implementation of necessary programs to demanded areas in grass root level.
General Objectives
General Objectives
To assess the need for a geographic information system for MOH staff, and to design, develop, implement GIS to be incorporated to ongoing eRHMIS system to analyse maternal and child health data.
- To assess the need for a GIS to MOH staff in analysing data on maternal and child health based on their geographical location.
- To identify the issues encountered in developing a PHM layer and ways to overcome and sort problem for more efficient outcome.
- To develop geographic boundaries of PHM areas based on GN divisions and sort out outlying areas to develop PHM Geographic map
Specific Objectives
METHODOLOGY
First stage
Done using "Randomizer App"
It is a randomizing tool that can generate random number or randomize lists.
According to inclusion and exclusion criteria, eligible Medical Officers were selected randomly proportionate to the number of Medical Officers of Health / Additional Medical Officers of Health employed in that respective province,using the list obtained from the respective PDHS and RDHS offices.
Finalized PHM boundies were then incoperated to DHIS 2 maps in eRHMIS
Component 2: Design and develop geographic boundaries of PHM areas
PHM area boundries then further edited using 'mapshaper'
PHM area boundries were made by desolving GN area boundries using QGIS software
Limitations
1
Transfer of trained staff
?
2
3
Inadequate IT infrastructure
Challenges and Drawbacks
Adjacent area margins
overlapping when constructing PHM area map
manually adjusting the overlapped margins was done
GN area is divided to more than one PHM area
2.1% (n=296)
were divided to several PHM areas,which made such divides a challenge when making a new PHM area map.
Coping up with frequently changing PHM areas
Mismatch in GN coordinates on “hierarchy operations” in DHIS2
It was difficult to
change the GIS system directly as it was based on GN area boundaries. It was burdensome
to change PHM area boundaries frequently, hence it was decided by FHB to make
changes of GIS maps only in 3-5 years duration
This problem was raised due to most of the GN areas were scattered throughout
the Sri Lanka without a proper arrangement.
CONCLUSION
- Majority of the participants agrees with the uses of GIS at MOH level.
- Participants were willing to try the PHM map at their institution.
- Majority agreed with the usefulness of PHM layer when analyzing maternal data.
- Familiarity of eRHMIS was an advantage when using the newly constructed PHM layer.
- It was a success when visualizing data with spatial information at grass root level
Recommendation
- Providing suitable hardware and connectivity
- Adding or deleting new PHM areas to be done in every five years to maintain stability of the maps
- Training programs for users on GIS highlighting each layer including PHM layer will enhance more usage of GIS in decision making.
- Further develop this map with much greater accuracy by using GPS devices at MOH level.
- Carry out training programs when new batches of MOHs and AMOHs reports for duty to maintain user acceptability and familiarity at a higher level.