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Health Workers Retention: Spatial Analysis of Basic Services Using GIS Technologies

Author(s): B. K. Mayala*1, J. Mshana1, V. Nyigo1, A. Mwisongo1
Affiliation(s): 1Health Statistics and IT, National Institute for Medical Research, Dar Es Salaam, United Republic of Tanzania
Keywords: Human Resource for Health, Health worker Retention, Spatial data, GIS
Background:

The study of spatial distribution of disease and health-related events in populations is a powerful tool for setting priorities for investigation, planning and control. Understanding the availability of basic services in a community is important. In Tanzania there is no proper system of collecting and managing data on existence of basic services. Therefore this information is deficient. The small amount of data collected is presented in a format that doesn’t reveal any spatial distribution of these services, such as where and how to access them in terms of distance.
Lack of basic services in some areas of the country is one of the major reasons for health workers to migrate to areas with better services and causing other areas to remain with few health staffs, therefore poor health care.
In this research GIS was used as a tool to determine the availability and distribution of basic key services that are important for health workers, and how they can access these services in terms of travel distance. Also GIS was used to establish a network that could consider geographic position and existence of key services that could influence retention of health workers.

Methods:

For each district visited, we assessed the various kind of basic services available in that particular area. Then a hand held Global Positioning System (GPS) was used to determine the geographic locations of those services, this includes health care, bank, water source, post office, police post, shops/open market location, schools and bus stops. ArcGIS 9.2 was used for spatial analysis of basic services; we had to make sure that the geocoded data are converted into a format that is compatible with ArcGIS. Therefore, data for the various services was converted into dbase format, where by database tables were created. These tables were then imported into a file geodatabase generated using ArcCatalog. Point maps were generated using ArcGIS, and then joined with other map layers so as to perform GIS analysis. The appropriate GIS analysis methods looked in this research are Buffer analysis and Point distance analysis which have potentials to determine at what distance a health worker could access the basic services in their respective districts.

Results/Conclusions:

Using the GIS data analysis tools, it was observed that most of the health facilities visited in some districts had neither piped nor well water. Results from this analysis revealed that some health worker can walk a long distance (up to 10km) to access water.
Results from this analysis shows that health workers especially from the remote areas can travel a distance up to 200km to access bank services with an estimated travel time of 4 to 10 hours or more, hence more costing. In this research we have presented GIS technology an approach to determine the spatial distribution of existing basic services for health workers. GIS has shown how a health worker can access basic services in terms of travel distance and time (Table 1). Buffer analysis and point distance analysis are the potential spatial analysis methods selected in this research to determine the distances to basic services.

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