1. Rocco Panciera- UNICEF
Session 3 –
How geospatial data and technologies could support the current microplanning process
Rocco Panciera- UNICEF

2. The current Situation
cEPI has identified the following information gaps in the current microplanning process
Improve knowledge of geographic characteristics of RHC and SubRHC  to support more efficient microplanning
Availability of accurate, verifiable information on distances (and travel times) between health facilities and EPI communities  to improve costing of microplanning
Improve information on barriers to immunization delivery associated with geographic accessibility and seasonal accessibility issues (e.g. difficult terrain, flood- prone areas)  to improve quality of microplans
Strengthen tools for visualization and mapping of EPI performance and resources  to equip township EPI team with the tools to identify gaps and inefficiencies to improve the EPI microplanning for better outcomes
Microplans
Health area maps

3. How can geospatial data and technologies support the current microplanning process in Myanmar? Let’s start by understanding the geographic dimension of the immunization program

4. The Geography of the Immunization Program
The delivery of immunization services involves the interaction (e.g. exchange of services, data, resources etc.) between a number of elements
The geographic objects relevant to the distribution & delivery of immunization services
Each of these elements is associated with a physical location on the surface of Earth
Each element with a physical location on the earth can be represented as a “geographic object” having a “geographic location”

5. The Geography of the Immunization Program
The interactions between geographic objects of the immunization program are very often dependent on their geographic location.
For Example: the distance between a community/settlement and the nearest health facility will have a significant impact on the utilization of services by the population of the population and the delivery of services

6. The Geography of the Immunization Program
One must also consider other geographic elements that allow for the physical connection between the geographic objects of the immunization program.
These are mainly
The geographic objects relevant to the distribution & delivery of immunization services
Administrative divisions
Reporting divisions
Transportation infrastructure (e.g. roads)
Landscape features (terrain relief, rivers, water bodies , landcover etc.)
In addition to that, one must also consider other elements that allow for the physical geographic linkage
between the objects forming the immunization program, namely (see also diagram in Figure 2):
• Administrative divisions or service delivery areas (e.g. national and sub national boundaries, health
districts, facilities catchment areas, etc.). Although largely a human convention, they have a
significant role on how immunization programs are planned, monitored and analyzed, and therefore
provide geographic context to spatial analysis and visualization.
• Transportation infrastructure (e.g. roads): along which vaccines are delivered to health facilities,
population travel to reach facilities or vaccination teams travel to deliver vaccination sessions etc.
• Landscape features (terrain, river, lakes, land cover etc.) which constitute the environment that he
population and the vaccine carrier will have to cross to reach a point of care as well as the source of
potential physical barriers to movement.

7. The Geography of the Immunization Program
One must also consider other geographic elements that allow for the physical connection between the geographic objects of the immunization program.
These elements collectively determine the channels and barriers through which population and services interact
In addition to that, one must also consider other elements that allow for the physical geographic linkage
between the objects forming the immunization program, namely (see also diagram in Figure 2):
• Administrative divisions or service delivery areas (e.g. national and sub national boundaries, health
districts, facilities catchment areas, etc.). Although largely a human convention, they have a
significant role on how immunization programs are planned, monitored and analyzed, and therefore
provide geographic context to spatial analysis and visualization.
• Transportation infrastructure (e.g. roads): along which vaccines are delivered to health facilities,
population travel to reach facilities or vaccination teams travel to deliver vaccination sessions etc.
• Landscape features (terrain, river, lakes, land cover etc.) which constitute the environment that he
population and the vaccine carrier will have to cross to reach a point of care as well as the source of
potential physical barriers to movement.

8. The Geography of the Immunization Program
The objects and elements of the immunization program can be represented as geospatial data in a GIS using 4 main types of geographic objects
3. Mobile-type objects
Community health Workers (CHW)
Midwives
Target population (e.g., children, pregnant mothers)
Means of vaccines transportation (Motorbikes, boat, etc.)
1. Point-type objects
Health facilities
Vaccination delivery sites
Vaccines storage and cold chain facilities
EPI communities (Settlement, city, towns, villages, hamlets, camp, wards)
Namely the four groups of geographic features include:
1. Objects with a fixed location whose geography can be simplified by a point (e.g., health facility, community/settlement, vaccines storage facility, etc.). The geography of these objects is obtained through their geographic coordinates.
2. Objects with a fixed location but whose geography has to be represented either by: . Polygons due to their much larger extent (Examples: administrative divisions, health facilities catchment areas, etc.) Lines due to their mainly longitudinal extension (e.g., road, river, etc.).
3. Objects which are mobile (i.e., don’t have a fixed location such as children, pregnant mothers, vaccination teams, vehicles, etc.). Such objects can be geographically represented as being attached o a fixed object (e.g. individuals in a community/settlement), or as a point whose geographic coordinates (latitude and longitude) change in time.
4. Continuous: some elements of our environment are not defined objects per say and not associated
with one specific location, but are rather distributed spatially. These are better represented using a
continuous surface (e.g. terrain, land surface attributes, population distribution)
2. Polygon & line-type objects
Administrative divisions
Reporting divisions
Roads, railways
Rivers
Water bodies
4. Continuous-type objects
Terrain
Land cover

9. The Geography of the Immunization Program
The immunization program also collects statistical information (e.g., number of vaccine doses delivered at a health facility, number of children < 1 year old in an EPI community, etc..)
Statistical information can be attached to specific geographic objects through the use of a unique Identifier.
Unique ID
EPI community POPULATION DATA
Health Facility Master List
Unique ID

10. Geospatial Technologies
Geospatial technologies form the set of technologies that facilitate the integration of geography into immunization programs.
These technologies refer to equipment used in measurement, analysis and visualization of earth's features, including the natural environment, human infrastructure and the elements of the immunization program:
Satellite Positioning System
Remote Sensing
GIS
Acquiring the geographic location of geographic
objects by recording their latitude and longitude coordinates.
Obtaining information about the earth’s surface feature from
satellites, aircraft or drones
An integrated collection of computer software and data used to view and manage information about geographic places, analyze spatial relationships, and model spatial processes

11. How can geospatial data and technologies support the current microplanning process in Myanmar?

12. How can Geospatial Data and Technologies support the Microplanning Process in Myanmar?
The different geospatial technologies come together to support the microplanning process:
Satellite Positioning System: used to acquire location of geographic objects core to the immunization program
EPI communities
Health facilities
Characterize location of health services with respect to target population

13. How can Geospatial Data and Technologies support the Microplanning Process in Myanmar?
The different geospatial technologies come together to support the microplanning process:
Satellite imagery: used to acquire information on the connecting environment
Hydrographic
network
(rivers, water bodies
Characterize geographic accessibility and barriers between health services and target population
Terrain relief
Seasonal hazards
(e.g. historic flood areas)
Land cover

14. How can Geospatial Data and Technologies support the Microplanning Process in Myanmar?
The different geospatial technologies come together to support the microplanning process:
GIS: used to manage, analyze, model and visualize the geospatial data
Perform spatial analysis (e.g. calculate distances between EPI communities and Health facilities)
Produce thematic maps
for decision-making and evaluation

15. How can Geospatial Data and Technologies support the microplanning process in Myanmar?
Gap: knowledge of geographic characteristics of RHC and SubRHC to support more efficient planning of health facilities catchment areas
Proposed support: Use of accurate GIS maps of SubRHC and RHC areas including geographic layout of health facilities, EPI communities and connecting environment
Hand-drawn maps
GIS maps

16. How can Geospatial Data and Technologies support the microplanning process in Myanmar?
Gap: Availability of accurate, verifiable information on distances (and travel times) between health facilities and EPI communities  to improve costed microplanning of ( currently limited to “CRASH” session types)
Proposed support: Use of AccessMod software for mapping physical accessibility and estimating distances and travel times between health services and EPI communities
Takes into account terrain morphology and landscape attributes
Uses multimodal transport process (e.g. walk, bicycle, motorized vehicles),
Accounts for travel in both directions (to and from health facility)

17. How can Geospatial Data and Technologies support the microplanning process in Myanmar?
Gap: information on barriers to immunization delivery associated with geographic accessibility and seasonal accessibility issues (e.g. difficult terrain, flood-prone areas)  to improve quality of microplans
Proposed support: Use of geospatial information on terrain elevation and flood prone areas to characterize areas with difficult accessibility or seasonal accessibility issues

18. How can Geospatial Data and Technologies support the Microplanning Process in Myanmar?
Gap: tools for visualization and mapping of EPI performance and resources  to equip township EPI team with the tools to identify gaps and inefficiencies to improve the EPI microplanning for better outcomes
Proposed support: Translation of microplanning data to thematic maps with indicators of RHC’s performance and microplans resources
Microplanning resources
RHC’s
performance?
Better planning

19. Thematic mapping in support of the microplanning process in Myanmar
Two types of maps will be used to achieve the desired objectives
Map Type 1: Base microplanning maps
Purpose: to support the microplanning process at RHC and SRHC level
Map Type 2: Monitoring & Evaluation maps
Purpose: to support M&E of microplanning at township level for the 6-months and annual reviews

20. Understanding the Process of Map Production and use
Base microplanning maps
Central
State/Region
Township
RHC/SRCH
Central
State/Region
Township
RHC/SRCH
S/R geospatial data manager supports updating of master lists
In collaboration with township focal person
Central level geospatial data manager maintain, complete and regularly update master lists and core geospatial layers + create travel time/distance matrices
-->Before Dec
Updated data communicated to S/R
S/R geospatial data manager undertakes annual update of base microplanning map
Base microplanning maps are distributed to townships
Dec
3. RHC/SRHC personnel use base microplanning maps for decision-making and supervision of microplanning
S/R geospatial data manager answers verification requests using geospatial data & base microplanning maps
Jan
TMO and EPI focal verify and approve microplans using previous 1 year M&E report (including M&E maps)
Feb
Request of GIS support
Microplans
(forms & completed base microplanning map)
S/R EPI officer verify and approve microplans using previous 2 years M&E report (including M&E maps)
Central officer EPI officer verify and approve microplans using previous 2 years M&E report (including M&E maps)
Mar

21. Understanding the Process of Map Production and use
M&E maps
Central
State/Region
Township
RHC/SRCH
Monthly report
(January – June)
Monthly report
(January – December)
SubRHC/RHC personnel collects population headcounts and immunization data from proceeding 12 months and project target population
Central level EPI officers maintain, complete and regularly update master lists and core geospatial layers
June
S/R geospatial data manager produces 6- months M & E Evaluation maps
Current year’s microplans
(forms & completed base microplanning map)
Updated master lists is communicated to S/R
TMO and EPI focal use 6 months evaluation maps to support mid-term EPI evaluation of microplanning
Dec
S/R geospatial data manager produces 12- months M & E Evaluation maps
TMO and EPI focal verify and approve microplans using previous 1 year M&E report (including M&E maps)
Feb
Back to microplanning maps
Evaluation maps are distributed to townships

22. Short term effort vs. long term benefit
The introduction of Geospatial Data and technologies requires an initial efforts
Initial effort to set up additional data vs. maintaining existing paper-based method might seem a lot
BUT consider the long term benefits
After the initial set up, updating the geospatial data, statistical data and connection between the two will require minimum effort
The connection of EPI program data to the ground reference (health facilities master lists) will make data management easier, more efficient and collaborative across health programs
Better planning and monitoring of vaccination activities resulting in increased coverage and more efficient management of immunization resources
Geo-enabling the immunization program will align with the geo- enabling of the National Health Plan.