District EPI (PAV) managers discussing the GIS map with health facility manager
Digital technologies can act as accelerators for the introduction, deployment, and scale-up of vaccines in countries. The use of digital tools and the data they enable facilitate rapid and scalable approaches to ensure vaccines are safely delivered to health facilities, that health workers are equipped to administer them, and that communities are informed and confident in their efficacy.
One such digital technology is the use of geospatial data, such as satellite images, GPS devices and Geographic Information System (GIS) software and tools to produce geospatially accurate local area maps to inform health service microplanning. Using spatial data on the location of populations, health resources and the surrounding environment, GIS-based microplanning maps can be produced in alternative to traditional, hand-drawn maps, to ensure all populations are accounted for, identify gaps in access to care, and optimize planning for outreach activities to ensure equitability and reach of services based on geographic evidence.
In November 2022, UNICEF’s Digital Health team visited Mozambique to support and document the initial phase of deployment of GIS-based microplanning maps in selected districts, in the context of a joint COVID-19 adolescent campaign and routine immunization activities.
During a dedicated district-level workshop in Mocuba district, Zambezia Province, health facility managers and EPI coordinators were guided in the interpretation of GIS-based microplan maps of their respective catchment areas, and their utilization to identify underserved communities, find optimal locations for outreach vaccination sites to improve access to vaccination services by such communities, and optimize the utilization of the scarce immunization resources.
This pilot project was the culmination of a multi-year effort led by UNICEF Mozambique, with technical support from UNICEF HQ, and in collaboration with the Clinton Health Access Initiative (CHAI) and the local governmental partner National Agency for Spatial Development (ADE). The partnership is aimed at geo-enabling the Reach Every District (RED) immunization approach utilized in Mozambique.
“The outcome was very positive. We were able to verify that the GIS maps can be interpreted and used by district and health facility managers to optimize service planning. Not only were they able to understand the benefits of the GIS maps for vaccination efforts, particularly with regards to identification of underserved areas and improving access of vaccination services – but several health facility managers also identified and proposed modification in the vaccination strategy of their areas based on the information provided in the GIS maps,” said Esmeralda Karajeanes , Immunization Specialist at UNICEF Mozambique Country Office, who co-led the mission with Rocco Panciera, Health Specialist at UNICEF HQ, who is providing overall technical assistance to the project.
The exercise was invaluable to document lessons and fine tune the strategy for scaling this effort in Mozambique. This is currently ongoing with progressive transition of technical GIS capacity to ADE to ensure long-term sustainability and continued technical support by UNICEF. Inclusive participation of local health staff is a crucial step towards ensuring relevance of the GIS microplan maps for the end-users. Moreover, many issues only became evident when discussing GIS maps in the field with the local health staff.
Multiple rounds of consultations may be needed to ensure that the GIS maps are tuned to the contextual geography, decision-making process and user needs in each region.