The health facilities and EPI communities master list for Myanmar Session 9 – The health facilities and EPI communities master list for Myanmar Nan Thida Phyo - MOHS Dr. Kaung Myat Thwin - MOHS

Master lists core to public health in Myanmar 4 main geographic objects Administrative divisions (Region/State, District, Township,Village track) Villages Ministry of Home Affairs Health facilities Reporting Divisions A master list is needed for each of these objects Ministry of Health and Sports 2

Master lists core to public health in Myanmar EPI communities Plantation Ward Camp … Villages Ministry of Home Affairs Ministry of Defense Ministry of Agriculture And irrigation ? EPI community Ministry of Health and Sports A master list is needed for this object as well 3

Master lists core to public health in Cambodia Geo-Registriy_Workshop_Final_Exec_Sum_010717.pdf https://www.healthgeolab.net/MEETINGS/CGR_2017/Geo-Registriy_Workshop_Final_Exec_Sum_010717.pdf 4

Master lists core to public health in Myanmar

The health facilities master list for Myanmar Session 9 – The health facilities master list for Myanmar Nan Thida Phyo – MOHS

Health facilities master list content What is an health facility? Few examples of definition: Medline Plus: Places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. Health authority Abu Dhabi: Standalone building with inpatient services for 24 hours use or longer by patients in the treatment of diseases, injuries, deformities, abnormal physical or mental status, maternity cases, nurseries and dispensaries. Free dictionary: Building where medicine is practiced. DOH Philippines: A building or physical structure providing health care. Wikipedia: in general, any location at which medicine is practiced regularly. Importance of the geography (location, place,..) Need to clarify few terms (health care, medicine,…)

Health facilities master list content What is an health facility? Additional definition: Health services (WHO): Health services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health. They include personal and non-personal health services. Health care (Wikipedia): Diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings Medicine (Collins English Dictionary): the science of preventing, diagnosing, alleviating, or curing disease Infrastructures included in the master list depend on the definition Pharmacies and mobile clinics would not be included here for example The definition used by the MOHS in Myanmar: “A building or permanent physical structure where health care is being provided”

Health facilities master list content The signature domain (2007)1 Good practice would be to have only one coding scheme Actually needs to be captured for each field together with the source Signature_domain_wp-07-91.pdf Direct link with the administrative divisions registry Core fields allowing to uniquely identify, define, locate and contact each facility Looked at these elements in relation to the current content of the health facility master list 1 http://www.cpc.unc.edu/measure/publications/wp-07-91/at_download/document

Health facilities master list content Uniquely identifying each facility Rules to choose an appropriate coding scheme 1. Ensure for the code schemes to be meaningless, meaning not to embed codes or other semantic meaning that could change through time in an identifier (e.g., admin division code, health facility type, etc.). Tororo hospital: UGA993001 What do I do when the information changes? Do not include such information in your coding scheme Capture these information as separated fields in your master list

Health facilities master list content Uniquely identifying each facility Rules to choose an appropriate coding scheme 2. Use a sequence as short as possible but taking into account the number of changes that could take place over the coming decades (function of the current number of health facilities observed in the country) Avoid long codes 148337353801198976578393 3. Using a check digit, such as the luhn algorithm (e.g., 1000001-3) or a specific set of characters at the beginning of the sequence (e.g. “HF”) to avoid the problems linked to having a “0” in front of it 08365222 The “0” disappears in some software starting with excel 4. Having the ID generated sequentially. (e.g., 100001, 100002, 100003,... or HF00001, HF00002, HF0003,...) 5. The code remains the same from the opening until the closing of the facility and this even if its name, type (upgrade) or location changes (because of a flood for example)

09 01 10 090110 Example of Cambodia Uniquely identifying each facility Coding scheme used until now in Cambodia Province OD Health facility 09 01 10 090110 The administrative division or Operational District (OD) in which the facility is located can change. Two options when there is a change Change the code: Loose the continuity in the database which is what happened and was a big problem for the MOH Keep the code: The content of the code looses its meaning The « 0 » in front can fall depending on the software you use (e.g. excel)

09 01 10 090110 Example of Cambodia Uniquely identifying each facility Coding scheme used until now in Cambodia Province OD Health facility 09 01 10 090110 The administrative division or Operational District (OD) in which the facility is located can change. Two options when there is a change Change the code: Loose the continuity in the database which is what happened and was a big problem for the MOH Keep the code: The content of the code looses its meaning The « 0 » in front can fall depending on the software you use (e.g. excel)

Health facilities master list content Uniquely identifying each facility All the other information are stored in the master list and past values are kept in the system 2017 2010 Example for Cambodia 2005 Allows following the changes that are occurring through time

Health facilities master list content Uniquely identifying each facility Official Health Facility Name Good practice: Capture the official name as used in the field In Myanmar language and English Include the name of the facility in full Include the health facility type to avoid names duplicates Might have to capture Township Might have to adjust the name in Myanmar language to capture the type + Capture past facility names

Health facilities master list content Uniquely identifying each facility Official Health Facility Name Issue of the Myanmar language fonts Excel Google spreadsheet Myanmar_Language_in_GIS_Datasets_MIMU.pdf Need to use UNICODE fonts to work well on in GIS software QGIS Applies to all the information captured in Myanmar language Depends on the fonts installed on your computer

Health facilities master list content Define each facility Health facility type Type of the health facility based on the official classification used in the country Currently available for public health facilities managed by the MOHS Needs to be completed for the private and the other governmental health facilities (MOHA, MOD)

Health facilities master list content Define each facility Ownership or managing authority Major classification: Government, Private The master list only includes governmental health facilities managed by the MOHs for the moment Sub-classification to be defined for both Government: MOHA, MOD Private: Single Proprietorship; Partnership; Corporation; Corporation; Cooperative; Foundation; Religious; Non-government Organization Or Private institution name

Health facilities master list content Locate each facility Address Street number and name (when it applies) Location in the administrative structure Official code and name of the Region/State, District, Township, Village track and Villages in which the health facility is locate Official name from the GAD gazetteer No official code for the moment but under discussion Using the Pcode from the MIMU database (not a master list) in the meantime + The administrative structure of the country also evolve through time Requires for an official and regularly updated master list of administrative divisions and villages

Health facilities master list content Locate each facility Geographic coordinates Latitude and longitude of the health facility expressed in decimal degrees together with the indication of the source, method and accuracy level attached to the coordinates (a separate field for each information) Longitude: ###.##### Latitude ##.##### Example for Myanmar Accuracy of the geographic coordinates currently in the master list is unknown and remains to be improved Reason for the Session 6 and Exercise 1 yesterday

Health facilities master list content Contact each facility Information needed to contact the health facility through different media including but not limited to the full name and position of the health facility head as well as the phone numbers (mobile, landline) and email address (to be captured in separated fields). Information to be completed in the master list Other important information to capture Health facility opening date Health facility closing date (when applicable) Operational status (active, inactive) … Information to be completed in the master list The Regions/States have an important role to play to establish and regularly update the master list

Health facilities master list content Data dictionary Defines what is recognized as the official source for each of the field Attaches a source and time stamp (start validity date) to each field for quality and monitoring 52 fields currently in the data dictionary

Session 9 – The EPI communities master list for Myanmar Dr. Kaung Myat Thwin - MOHS

EPI communities master list content What is an EPI community? Any inhabited place observed in the country The sum of the population living in EPI communities at a given time cover both the total population and the one eligible for vaccination in the country. Such place can present different population’s presence status: Short term Settlement setup for a period shorter than 1 year Long term Settlement setup for a period longer than 1 year Seasonal Settlement setup temporarily over the same period every year

EPI communities master list content What is an EPI community? Such place can be of different type: Type Definition Population's presence status options Ward 4th level administrative divisions encountered in urban areas and officially recognized by the GAD long term Village long term settlement officially recognized by the GAD Army Settlement managed by the Ministry of Defense short term, long term, seasonal Camp Settlement typically settled for displaced population (refugees or internally displaced population for example) short term, long term Workers settlement Settlement setup by workers to live close to their place of work (plantation, factory, building site, mining site…) Other settlement Any other inhabited place not covered by the other definitions

EPI communities master list for Myanmar Plantation Ward Camp … Village Ministry of Home Affairs Ministry of Defense Ministry of Agriculture And irrigation ? EPI communities Complex object!! Ministry of Health and Sports 26

EPI communities master list content for Myanmar Plantation Ward Camp … Village ?? ?? ?? Administrative divisions master list Master list 2 Master list 3 Master list … EPI communities EPI communities Master list Does not exist for the moment 27

EPI communities master list content for Myanmar How could it look like? We did the exercise in preparation for this training 25 fields capturing: The EPI community code, name, type, population presence status and location as per the cEPI database For EPI communities that are villages: MIMU Pcode and GAD official name of the Region/State, District, Township, Village Track and Village as well as geographic coordinates from the MIMU database The official code and name from the DOPH health facility master list for the 1st and 2nd level health facility to which the EPI community is attached to

EPI communities master list content for Myanmar How could it look like? Required quite some work to be created MIMU villages not appearing in the EPI communities master list and EPI communities reported as villages not appearing in MIMU’s database Geographic coordinates missing for several communities Will require for some more work and the help from the Magway Region MOHS staffs to be first completed and then regularly updated …and then this would need to be expanded to cover the whole country!!

EPI communities master list content for Myanmar The unique ID in the EPI communities master list you will use during the training EPI00000001 Temporary EPI community ID: Same approach as for the health facility master list 8 numeric digits as there are more than 70,000 villages in the country MMR009004016 MIMU Pcode for administrative divisions: 185343 MIMU Pcode for villages: Health facility ID (DOPH master list) HF000001