From paper maps to digital maps: enhancing routine immunisation microplanning in Northern Nigeria

Abstract

Geographical information systems (GIS) can be effective decision-support tools. In this paper, we detail a GIS approach implemented by the Bauchi and Sokoto state primary healthcare development agencies in Nigeria to generate and convert routine immunisation (RI) paper maps to digital maps for microplanning. The process involved three stages: primary and secondary data collection and reconciliation, geospatial data processing and analysis, and production and validation of maps. The data collection and reconciliation stage identified a number of challenges with secondary data sources, including the need to standardise and reconcile health facility and settlement names. The study team was unable to apply population estimates generated from the Global Polio Eradication Initiative to RI planning because operational boundaries for polio activities are defined differently from RI activities. Application of open-source GIS software enabled the combination of multiple datasets and analysis of geospatial data to calculate catchment areas for primary health centres (PHCs) and assign vaccination strategies to communities. The activity resulted in the development of PHC catchment area digital maps, and captured next steps and lessons learnt for RI microplanning in the two states. While the digital maps provided input into the microplanning process, more work is needed to build capacity, standardise processes and ensure the quality of data used to generate the maps. RI service providers and communities must be engaged in the process to validate, understand the data, the contextual factors that influence decisions about which vaccination strategies RI microplans include and how resources are allocated.

Every Child on the Map: A Theory of Change Framework for Improving Childhood Immunization Coverage and Equity Using Geospatial Data and Technologies

“…These sketch maps are often not to scale; inaccurate or incomplete; and do not contain crucial information for microplanning such as distances, road conditions, or geographic barriers that may delay or discourage vaccinator teams from reaching remote areas during door-to-door campaign activities [ 3 , 16 ]. Health system data may contain overlapping borders; settlements that fall outside health boundaries; and inconsistencies in naming, spelling, and classification of service delivery units and settlements [ 2 , 4 ]. The planning tools and delivery strategies to reach all children with immunization services need to expand beyond the current methods to incorporate new digital tools that support local immunization managers to identify and reach areas that have been historically left off maps and microplans [ 17 ].…”

“…The visual power of the map is aided by modern advances in technology, computing, and handheld devices that can record the location of any place on the earth and transmit geospatial data for analysis, sharing, and use. The use of geography to analyze patterns of disease, distribution of populations, and Immunization programs in low-and middle-income countries are beginning to harness digital maps and geospatial data to display and analyze complex information for program improvements [1][2][3][4][5][6]. The effective use of geospatial data can show program managers which locations have not received adequate immunization services, provide more accurate denominators, and inform what vaccination delivery strategies should be used to optimize coverage and equity.…”

A microplanning model to improve door-to-door health service delivery: the case of Seasonal Malaria Chemoprevention in Sub-Saharan African villages

“…In clinical trials, households and participants are pre-identified and health workers trained to access them using rough sketch maps [ 26 ]. During campaigns, households are likely to be missed if biases in defining catchment areas are initially introduced in sketched paper maps or if such paper maps are not used that all [ 13 , 15 , 27 ].…”

A microplanning strategy to improve door-to-door health service delivery: The case of Seasonal Malaria Chemoprevention in Sub-Saharan African villages

“…In clinical trials, households and participants are pre-identified and health workers trained to access them using rough sketch maps [26]. During campaigns, households are likely to be missed if biases in defining catchment areas are initially introduced in sketched paper maps or if such paper maps are not used that all [13, 15, 27].…”