1. Use of GIS to support PEPFAR Côte d’Ivoire
2017 PEPFAR Data and Systems Applied Learning Summit
Use of GIS to support PEPFAR Côte d’Ivoire
September 19, 2017

2. Context: Data Flow in the Health System
Hierarchical structure :
Central level
20 health regions
82 health districts, with an average of 4 district per health region (2 to 6 districts /region).
About 2,000 public health facilities
About half being rural health centers at the lowest level of the health pyramid
about 250 urban health centers
4 university hospitals
18 regional hospitals
53 general hospitals
72 district hospitals among others
33 private clinics currently provide ART (44 planned for FY 18)
Strategic
Centr.
Regions (20)
Districts (82)
Sites (+2,000)
Reports compilation & consolidation
Feedback /supervision
Data aggregation/ some data entry
Management decisions
Data aggregation/ some data entry
Reports
Operational
Primary data collection forms
Date entry/reports

3. Brief Evolution of Mapping in CI
In the beginning of PEPFAR in CI in (emergency response phase): much less management of sites, areas, or geography
Basic use of maps
During phase II: Closer look at how partners are operating in the field in order to minimize overlap and look for efficiencies
In 2012: Efforts to build more structured GIS database and mapping Who is Doing What, Where
Extensive use of GIS mapping to help that process

4. Key Examples of GIS and Spatial Analysis Use
Partners rationalization 2013
COP 14 shifts and COP 15 pivot
DHS 2011/2012 results analysis and mapping secondary analysis results
Mapping for the Economic Vulnerability Study (ASPIRES)
Some advanced spatial analysis and visualizations: Geographical analyses of site level and district level HIV data, including retention patterns, Testing and ART coverage and gaps,…
GIS innovation project in FY 18

5. 2013 Partners rationalization process
Using GIS to better understand interventions in the field (who is doing what where?)
2013 Partners rationalization process

6. This is an example of overlapping activities in 2012: difficult to map
Geographical challenge: clinical partners by district in 2012
This is an example of overlapping activities in 2012: difficult to map
PEPFAR Clinical partners overlapping geographically before 2013
Challenges with GF sites transition

7. 1 clinical partner per district except Abidjan
Results of 2013 partner rationalization with GIS Analysis
1 clinical partner per district except Abidjan
This helped streamlining, standardizing, and integrating program data for better analysis and decision making
There was similar challenge with Community interventions

8. Using GIS analysis for COP 14 shifts and COP 15 pivot

9. Analysis based on multivariate analysis at Regional level
COP 2014 shifts to Prioritization at Regional Level
Scale-up plans in Priority Areas and Populations
Analysis based on multivariate analysis at Regional level

10. COP 2015 pivot: Multivariate analysis of disease burden
District categorization for clinical services
Example - Map of Percent of PLHIV by district and projected districts to be saturated by FY17, classified by quartile

11. COP 2015 pivot: Multivariate analysis of disease burden
District categorization for clinical services
16 scale-up to saturation districts have 34% of the total disease burden
23 Aggressive scale-up districts have 40% of the total disease burden
Together 39 Scale-up districts represent 74% of the disease burden
40 Sustained districts represent 23% of PLHIV

12. Are we in the right places?
Verifying alignment of district prioritization with results every quarter
FY 14
FY 16
FY 15

13. Are we in the right places?
Verifying alignment of district prioritization with results every quarter

14. Identification of low volume ART sites: FY16
 Low – High volume ART sites
Total number of ART sites
636
Low volume ART sites
(<= 25 patients)
196
High volume ART sites
(> 1,000 patients) 28

15. Alignment of OVC programs
Collaboration with Global Fund: FY 17
Alignment of OVC programs

16. DHS 2012-2013 results analysis and mapping secondary analysis results

17. HIV Prevalence by Region
2005
2012
Increase in Centre-Nord, Nord-Ouest, Ouest et Sud-Ouest regions
Decrease in the other regions

18. Mapping for economic vulnerability study for OVC program (ASPIRES)

19. Community level mapping:
Beneficiary status

20. Example Map of distance to closest Health Facility for Communities in Bouake

21. Parallel Coordinates Plot
5. Advanced spatial analysis and visualizations
Hotspot Mapping
Multivariate visualization and exploratory data analysis
Self-organizing map and Multidimensional scaling
clustering
Charts and Visualizations
Self-Organizing Map (SOM)
Parallel Coordinates Plot
Visualizing individual SNU trends: Visualization of HCT_pos, Care_New and Tx_New
Dabou

22. 6. GIS innovation in COP17: Open Geodata Center
Objectives:
To improve access to HIV services and reach people most at risk
To improve understanding of HIV/AIDS program coverage an gaps at community level
Support DREAMS like activities (girls roster, map vulnerability, risks, GBV, educational attendance, family planning needs, …)
Building data literacy and capacity for data use among the government, Civil Society Organizations, Communities and other stakeholders
Promote use of Open data for GOCI
Stakeholder engagement, alignment of data sources, hub of collaboration
Products
Open data Lab
Web maps / Story maps
Platform for Data analysis &visualization, Dashboards
OpenStreeMap
Online information resources
Intended users: Civil Society Organizations, Communities, Service providers, government, and other stakeholders

23. 6. GIS innovation in COP17: OpenDCH functionality
Existing data captured from existing systems such DHIS2, national statistics and surveys and PEPFAR data
New data such as OSM in certain areas in Abidjan, San Pedro, Yamoussoukro and Bouake
Men’s hotspots
DREAMS beneficiaries
Data sources
Structure of the OpenDCH system:
Real-time location of population of interest (men hotspots, girls roster, randomized position of key pop sites,…)
Real-time location of HIV services - Services Near You, Service availability, schedules, opening hours, directions to the service point,…
Selection of datasets for download
Integrated Visualization platform
Data Analytics (maps, graphs, …)
Advanced analysis based on the policy and program analysis questions
Selectable multiple views dashboards for key program indicators
Customized reports with selection of location and indicators 23 23

24. Prototype Web/Story Map for HIV Program Data

25. Prototype Map Gallery
A catalog of all maps produced by the PEPFAR program. Can be viewed by title, date, etc

26. Prototype Interactive Visualization
Selection of a district to view key data elements

27. Thank You!
Questions?