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

Leanna Sudhof*, Cheryl Amoroso, Peter Barebwanuwe, Fabien Munyaneza, Adolphe Karamaga, Giovanni Zambotti, Peter Drobac, Lisa R. Hirschhorn

*Corresponding author for this work

Research output: Contribution to journalArticle

21 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)18-26
Number of pages9
JournalTropical Medicine and International Health
Volume18
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • Access to health care
  • Geographic information systems
  • Maternal mortality
  • Regional health planning
  • Rwanda

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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