Approaches to health Facility Data Collection and Mapping

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Approaches to health Facility Data Collection and
Mapping

• Bolaji Fapohunda, PhD.
• Dai Hozumi, MD, MPH
• JSI, Inc
• 29 March 2006

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Acknowledgement

• Dai Hozumi
• for the presentation given the 2005 Mini MAQ
  University, in collaboration with Bolaji
  Fapohunda. That work is the source document for
  many of the Slides in this presentation

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Objectives of this session

• Discuss the role of health facility mapping in
  strengthening health service delivery
• Disseminate key approaches to HF mapping,
  including advantages and disadvantages of
  specific approaches

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Presentation outline

• Role of health facility mapping/assessment
• What is it, what it does and what does not do
• Differences between health facility mapping and
  population based surveys
• Key approaches to health facility mapping
• Service Availability Mapping (SAM)
• Service Provision Assessment (SPA)
• Health Facility Census (HFC)
• VCT and PMTCT mapping
• Conclusion

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Definition

• Facility Any site where clients receive formal
  sector health services
• May includes temporary sites/outreach service
  sites
• Includes stand-alone VCT maternity homes
  hospices
• Includes private doctor offices (limited
  availability of information thus far)
• Source Fronczak, Nancy. 2006

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Why collect data on HF

• Huge investments in the formal health sector
• Construction and infrastructure development
• Procurement of equipment and supplies
• Procurement of medicines
• Training
• Pilot projects to strengthen service delivery and
  systems (for specific services)
• Source Fronczak, Nancy. 2006

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What are the key questions answered by HF data?

• Quantity and availability of services
• Where are the service delivery points?
• What services available?
• In what quantity/frequency?
• How many health workers are working?
• Quality of services
• Is there a standard of care guidelines? Are they
  being used?
• Are health workers adhering to the guidelines?
• Support mechanism
• Condition of building
• Availability and condition of equipment
• Availability of supplies
• Management systems and practice

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Health facility versus population household based
surveys
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Pathway to Child Survival Pediatric
HIV/AIDS (adapted from Waldman Bartlett, 2000)
Safest feasible infant feeding
Mother provides safest/feasible IYCF, Vit A
Zinc suppl.
Infant is HIV positive
Mother recognizes signs and symptoms
Wellness
INSIDE THE HOME
Mother continues to give safest/feasible IYCF,
Vit A Zinc supplementation
Improved child health
Provider gives appropriate HIV/AIDS care Rx
based on need /or clinical staging
community- based treatment/care
Growth monitoring CTMZ Micronutrients Water/
sanitation ART adherence counseling
Mother seeks care counseling for signs and
symptoms
OUTSIDE THE HOME
Provider gives appr. HIV/AIDS care Rx.
Facility-based treatment/care
Referral Level care
Mother accepts referral
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Key questions answered by Population-based surveys

• What proportion of the population is using
  services?
• What is the characteristics of individuals/
  households who are using services vis-a-vis those
  who are not?
• What are the key facilitating and constraining
  factors to service utilization?
• What are the socioeconomic differences in
  morbidity and mortality levels?
• How are health outcomes impacted by access to
  services?

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Advantages of HF data

• Contribute to health system strengthening
• Important component of the national HIS
• Increase the domains of data for investigation,
  making triangulation possible
• HF data can help determine whether population
  based surveys are necessary, saving costs (e.g.
  the IMCI-MCE Survey).

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Characteristics of system strength affected by
HF mapping

• Provisions of basic services
• Well integrated complementary services
  public/private, static/outreach, different
  levels (pry, secondary, referral)
• Efficient use of facility resources, including
  personnel, infrastructure, equipment, supplies
  and time
• Existence of coordinating mechanisms among key
  levels and programs outreach departments,
  community workers etc
• Ownership by, support for, national/community
  counterparts
• RHIS/monitoring evaluation systems

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Profiles of key approaches
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Key approaches

• Service Availability Mapping(WHO)
• Service Provision Assessment (ORC Macro/USAID)
• Health Facility Census (JICA)
• Facility Audit of Service Quality (UNC/USAID)
• VCT and PMTCT Mapping

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Service Availability Mapping
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Service Provision Assessment
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Health Facility Census
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Estimated cost of capital investment requirement
for Malawi 2004 - 2009
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Facility Audit of Service Quality
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VCT/PMTCT Mapping
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Displaying HF data

• May display data using simple basic maps or
  advanced maps

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• Basic versus advanced mapping
• dot map or shaded polygon map displays simple
  patterns and geographic dispersions.
• Choropleth, or shaded polygon maps can also be a
  valuable way to display geographic data.
• Software requirements for basic mapping EpiMap,
  SIGEpi (produced by PAHO), Healthmapper (WHO) as
  well as
• ArcGIS.
• Source Spencer, John. 2006

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• Advanced Mapping key is that data is explored in
  greater depth to produce fuller understanding of
  the geographic patterns. Require more
  sophisticated program such as ArcGIS, and
  additional training.
• Basic mapping may be transitioned to more
  advanced mapping if relevant information is
  available and there is adequate planning at the
  start of the Project
• Source Spencer, John. 2006

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• Thank You ?

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Contact

• Bolaji Fapohunda bfapohunda_at_jsi.com
• Dai Hozumi dhozumi_at_jsi.com