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 language | English (US) |
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Pages (from-to) | 18-26 |
Number of pages | 9 |
Journal | Tropical Medicine and International Health |
Volume | 18 |
Issue number | 1 |
DOIs | |
State | Published - 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