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Trop Med Int Health. 2013 Jan;18(1):18-26. doi: 10.1111/tmi.12016.

Local use of geographic information systems to improve data utilisation and health services: mapping caesarean section coverage in rural Rwanda.

Author information

1
Women and Infants Hospital, Providence, RI, USA. LSudhof@wihri.org

Abstract

OBJECTIVES:

To show the utility of combining routinely collected data with geographic location using a Geographic Information System (GIS) in order to facilitate a data-driven approach to identifying potential gaps in access to emergency obstetric care within a rural Rwandan health district.

METHODS:

Total expected births in 2009 at sub-district levels were estimated using community health worker collected population data. Clinical data were extracted from birth registries at eight health centres (HCs) and the district hospital (DH). C-section rates as a proportion of total expected births were mapped by cell. Peri-partum foetal mortality rates per facility-based births, as well as the rate of uterine rupture as an indication for C-section, were compared between areas of low and high C-section rates.

RESULTS:

The lowest C-section rates were found in the more remote part of the hospital catchment area. The sector with significantly lower C-section rates had significantly higher facility-based peri-partum foetal mortality and incidence of uterine rupture than the sector with the highest C-section rates (P < 0.034).

CONCLUSIONS:

This simple approach for geographic monitoring and evaluation leveraging existing health service and GIS data facilitated evidence-based decision making and represents a feasible approach to further strengthen local data-driven decisions for resource allocation and quality improvement.

PMID:
23279379
DOI:
10.1111/tmi.12016
[Indexed for MEDLINE]
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