Approaches to health Facility Data Collection and Mapping

1. Approaches to health Facility Data Collection and Mapping Bolaji Fapohunda, PhD. Dai Hozumi, MD, MPH JSI, Inc 29 March 2006

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. Health facility versus population household based surveys

9. 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 &/orclinical 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 Facility-based treatment/care Provider gives appr. HIV/AIDS care & Rx. Referral Level care Mother accepts referral

10. 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?

11. 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).

12. 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

13. Profiles of key approaches

14. 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

15. Service Availability Mapping

16. Service Provision Assessment

17. Health Facility Census

18. Estimated cost of capital investment requirement for Malawi 2004 - 2009

19. Facility Audit of Service Quality

20. VCT/PMTCT Mapping

21. Displaying HF data May display data using simple basic maps or advanced maps

22. 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

25. 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

27. Thank You 

28. Contact • Bolaji Fapohunda: bfapohunda@jsi.com • Dai Hozumi: dhozumi@jsi.com