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When GIS Really Works: Health Systems 20/20's Yemen Health GIS Project

Using GIS to Improve Health Resource Allocation in Yemen

Health Information Systems/Geographic Information Systems (HIS/GIS) tools and applications developed by Health Systems 20/20 in Yemen allow anyone to visually explore patterns in health indicators and identify service gaps, such as staffing, drugs, equipment, infrastructure, underserved populations, and inaccessibility to health facilities, in order to prioritize resource allocations.

A health GIS toolkit, designed as an extension for ArcView GIS software, such as the one used in Yemen, can be readily transferred to any country context. The Health Analyzer runs on a CD-ROM and allows decision makers with access to a computer the ability to use GIS data to inform decisions and visualize results. Governorate and district health officials without access to a computer have been provided with a health facility atlas which includes maps of precise geographic locations, photos, and summary information about health facilities.

The success of the project encouraged the MoPHP to scale it up on a national level. With funding from the World Bank, the health facilities survey and the GIS mapping were conducted for all governorates. The data is being used by the government and other organizations working with human resources for health (HRH). For example, district health officials are using the GIS atlases, maps, viewers, and Health Sector Analyzers (an analysis capability of GIS) to justify and reallocate HRH.

Due to the utility of GIS technology, Amran requested an update of the GIS/Healthy Analyzer database, which was developed during a previous project. The 2010 survey found the number of health facilities in Amran had increased by 42% to 331 facilities since 2005. Data from the health facility survey will be integrated into the national GIS health database and used to prepare a new Amran health atlas.

A Step-by-Step Example of How the Yemen GIS Tool is Used

• Research question: What are the gaps in availability and accessibility of immunization services in Amran Governorate, Yemen?

Below is an example of a health GIS sample analysis used to identify gaps in immunization services in Amran Governorate.

Step 1: Plot population areas by size (PURPLE points) and identify health facilities with immunization services and vaccine refrigerator using the Facility Survey Analyzer (YELLOW points).

Step 2: Analyze the immunization services network by dividing area according to closest proximity to service provider (LT GREEN area) using Service Network Provider tool.

Step 3: Analyze 60-min walking accessibility/coverage area (BLUE) using the Facility Accessibility Mapper.

Step 4: Analyze population-weighted gaps in immunization coverage and target prioritized areas or health facilities for intervention (RED vs. YELLOW or GREEN areas) using the Healthcare Gap Analyzer.

Step 5: Evaluate immunization gaps compared to an analysis of 60-min accessibility area for immunization services added to user-selected existing facilities (WHITE area) and/or initiated at potential new facilities (GRAY area).

• Results:

Adding immunization services to the two health facilities highlighted (WHITE area) appears worthwhile for rapid enhancement of the immunization coverage area. Additionally, evidence-based justification for construction of a new health facility based on immunization coverage needs can be visualized by identifying a new location and mapping its 60-min accessibility area (GRAY area).

As a result, governorate health officials can more efficiently target limited resources to provide new immunization services at select existing facilities (WHITE area). Duplication in adequate immunization services coverage area (overlapping LT BLUE areas) may be revealed and could warrant reallocation of vaccine refrigerators combined with training of health care providers in facilities with new immunization service capacity. Tracking immunization resources and eliminating duplication in coverage could result in significant health care cost savings while at the same time increasing accessibility of vaccines. In addition, potential health facility site locations or areas that would greatly benefit from mobile vaccination campaigns can be identified (GRAY area).