1. THE GEOGRAPHY OF MATERNAL AND NEWBORN HEALTH: THE STATE OF THE ART Steeve Ebener, Maria Guerra-Arias, James Campbell, Andrew J. Tatem, Allisyn Moran, Fiifi Amoako Johnson, Helga Fogstad, Karin Stenberg, Sarah Neal, Patsy Bailey, Reid Porter and Zoe Matthews
Supported by:
And convening a platform of partners:
Health GIS 2013
Bangkok
August 23rd, 2013

2. Mapping for Maternal and Newborn Health
3 key objectives: 
A platform of global partners exploring the innovation, potential and added value of using GIS technologies to accelerate progress on MDGs 4 and 5;
MNH mapping, research and analysis from selected countries synthesized in a working paper and scientific publication;
A concept note on the scale-up of ‘Mapping for MNH’ activities in , to progressively cover all 49 low-income countries targeted by the EWEC campaign.
The paper relates to the 1st and 2nd objectives

3. The context
MDGs goals linked to maternal and newborn health are the least likely to be achieved by 2015
Critical to ensure that all possible data, tools and methods are fully exploited to help address this gap
Geographic Information Systems (GIS) allow a more in-depth analysis of the causes and factors behind adverse Maternal and Newborn Health (MNH) outcomes
Important to know current state of the art in mapping the geography of MNH as a starting point to unleashing the potential of these approaches

4. The context Neonatal mortality rate per 1000 live births in 2011
UN Inter Agency Group for Child Mortality Estimation
Maternal mortality ratio per
live births in 2010
Trends in Maternal Mortality report

5. The context Southampton meeting (March 2013)
First meeting among institutions interested or working on the use of GIS in MNH
Literature review

6. Result of the literature review
Identified 24 studies with a focus on MNH
relatively few compared to other health focus areas
Main findings
clear increase in the number of GIS for MNH publications since 2010
Africa has received the greatest research focus with 13 studies matching therefore the region with the highest maternal and infant mortality levels
Mostly national and sub national studies
Different objectives and GIS methods

7. Result of the literature review
Thematic mapping
(17%)
GIS methods
Spatial analysis 1
(54%)
Objective of the study
Spatial modeling 2
(29%)
Other
(33%)
Geographic access (67%)
1 Straight-line distance, buffer
2 Use of a mathematical model to measure travel time

8. Geographic access to MNH care - examples
Spatially distributing the demand (pregnancies and births)

9. Geographic access to MNH care - examples
Visualizing and improving the MNH referral system
Improving transportation/ communication
Upgrading selected facilities
Bailey P, Keyes E, Parker C, Abdullah M, Kebede H, Freedman L. Using a GIS to model interventions to strengthen the emergency referral system for maternal and newborn health in Ethiopia. Int J Gynecol Obstet 2011; 115:

10. Geographic access to MNH care - examples
Looking at different scenarios and combining the results with population information
Facilities offering care at birth
CEmOC Facilities
Gething, P.W. et al., Geographical access to care at birth in Ghana: a barrier to safe motherhood. BMC public health, 12.

11. Geographic access to MNH care - examples
Adding human resources and service utilization information

12. Moving towards a comprehensive GIS for MNH
Work presented here could greatly benefit countries to assess and act on constraints to equitable provision of health services to women and children;
Each of the GIS method (thematic mapping, spatial analysis or modeling) adds specific value to the policy discussion.
Several challenges nevertheless remains for this to be possible (weak information system, lack of resources,..)
The health sector could use the increased emphasis on MNH as the driver to improve GIS capacity, thus benefiting not only MNH programs but other health initiatives as well.

13. Moving towards a comprehensive GIS for MNH
This would be possible through the establishment of an institutional framework in which:
1) The health sector is actively involved in the NSDI process;
2) Health partner involved in MNH priority countries strengthen the existing GIS capacity independently from the health program they support;
3) Institutions involved in the strengthening of health information systems include the integration of geographic and time dimensions in their approach;
4) MNH oriented programs systematically consider geographic analysis and GIS as a tool to improve the implementation and monitoring of MNH programs.

14. Thank you for your attention !
Share your knowledge, expertise, experience or interest !
If you are interested in the joining the platform of partners, please contact:
Thank you for your attention !