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GIS Methods: Applications to HIV and Family Planning

GIS Methods: Applications to HIV and Family Planning. Livia Montana UNC-Chapel Hill, Carolina Population Center Measurement, Learning & Evaluation Project Identifying Populations at Greatest Risk of Infection - Geographic Hotspots and Key Populations Geneva, July 25-26, 2013.

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GIS Methods: Applications to HIV and Family Planning

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  1. GIS Methods: Applications to HIV and Family Planning Livia Montana UNC-Chapel Hill, Carolina Population Center Measurement, Learning & Evaluation Project Identifying Populations at Greatest Risk of Infection - Geographic Hotspots and Key Populations Geneva, July 25-26, 2013

  2. Data Availability • Health facility data • Census • Surveys • Surveillance • Routine information systems • Outreach and community based services • Population surveys

  3. Mapping Results: Monitoring and Measuring Progress Towards Targets and Goals • How can GIS methods be used to link and triangulate these data sources? • Identify populations at risk • Update temporal and spatial scales of maps of populations at risk • Understand differences in estimates across varying temporal and spatial sources • How can GIS methods help inform planning and programs to better serve those in need? • Can we link quality and availability of services to population-level outcomes?

  4. Montana, Mishra, Hong 2008.

  5. Comparing HIV Prevalence from Sentinel Surveillance Sites and DHS Data

  6. Using GIS to Inform Programs: Family Planning (FP) • Urban Reproductive Health Initiative (BMGF) • Integrate FP services • Improve quality • Increase access • Reach the urban poor • 5-year prospective evaluations in each country

  7. Measurement, Learning & Evaluation Project:Evaluation Design • Large Longitudinal Samples • To measure causal impact of the program • Small Cross Sectional Surveys • To measure change in key indicators between baseline and endline • Facility Surveys • All facilities mentioned in the individual survey • Random sample of additional facilities • Census of high volume facilities • Public and private facilities • Longitudinal

  8. Linking Family Planning Users to Health Facilities: Supply & Demand • Where did you go for services? • Distance calculations from primary sampling unit (PSU) to facility • Preferred providers • The most popular provider in the PSU • What is the quality of services in your geographic area? • Buffers around PSUs • Census of facilities measured at baseline and midterm • Quality measures from facility surveys

  9. Innovations in Evaluation • Urban women can chose from many facilities to get their family planning counseling and contraceptive methods • Urban women may not even consider sources close to their residence • Choice of facility is intricately linked to the choice of contraception • Program evaluation methods that simply link individuals to nearby facilities may include a completely incorrect choice set

  10. Unanswered Questions • Geographic access to services in urban areas • Does distance matter in urban settings? • How does quality of services influence choice and uptake? • Do women choose higher-quality facilities? • Do family planning users or new adopters choose higher-quality facilities?

  11. Challenges and Future Directions • Availability of health facility locations • Census, and survey data • Ability to link reported facility names to the master list of facilities • How to map the extent of community-based activities (community health care workers, outreach etc)

  12. …challenges and future directions • Continued development of methodologies that combine geographic information to generate small-area estimates • Validation of small-area estimates of HIV prevalence, and populations at risk • Need for rigorous evaluation methodologies combining GIS and other methods to assess causal relationships and program impacts

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