Mapping Health information - DHIS capability enhancement through GIS visualization -

1. MappingHealth information- DHIS capability enhancementthrough GIS visualization - - ”To support the development of an excellent and sustainable "health information system" that enables all healthcare workers to use their own information and to improve the coverage and quality of healthcare within our communities” – through geographical visualisation GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

2. Why Using Maps? • Human natural abilities to distingush and interpret colors, patterns, spatial relationships • Maps ability to provide distributions, relationships, and trends of data GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

3. GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

4. AGENDA: • Purpose, background and description of the suggested ‘3G-concept’ : GIS on three levelsto achieve necessary flexibility: GIS for health workers, analysis and data mngt, WWW. - preliminary prototypes: • (1) Maps in DHIS (Integrated Vis.) • (2) Advanced analysis and map information management • (3) Internet ( Web based Vis.) • Recommendations – next step GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

5. Vision Statement • Enable Health workers to map their challenge, effort and improvements • Enable decision makers to get the bird's-eye view – and ability to zoom into actual details - the ‘individual‘ case. • To increase community awareness and participation in health care issues. GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

6. The Challange • Client: “The project wants to use the GIS mapping AS A TOOL TO identify, analyze and monitor health systems performance. The project aims to develop a distributable version of GIS software with screens for data entry, generation of maps, and analysis of data. Any distributable version is free from licensing and helps to disseminate the software without paying heavy licensing fees and eliminates the complexities of the GIS software to the end user who are district management and state health management (at least 30 copies will be used) “ GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

7. Our approach • Evaluate existing GIS solutions • Develop a concept that takes care of critical aspects, (management of digital maps, avoid uneccesary complexities etc) • Deliver a concept for GIS in HISP – before putting to much effort in one single part of the overall solution • Contribute to an open-ended process • Visit the client GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

8. Goal and Objective • A combined solution: • An integrated easy to use, flexible solution that gives the health worker overview and ability to zoom in into details (according to clients demand) • A tool for management of map information (e.g. PHC coordinates) and advanced analysis. • Publication of Health information using maps • KISS – keep it small and simple GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

9. Today’s Situation Free, open source MS-Access based Software, Interface to GIS: ArcExplorer from ESRI (Free) GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

10. Today’s Situation • ArcExplorer • + enables visualization from DHIS • - complicated integration • - poor data management (base map etc) • … should be considered as an element in a the future solution • Axio Map (link) • … has not been thoroughly evaluated by us and should be considered as an interesting option GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

11. How Did We Get Here? • ArcExplorer • Free • Well tested • Stand alone GIS visualization • Uses shape-files – industry standard • Axio Map • Internet – makes information available • Overview GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

12. AdvancedGIS Suggested concept: “3G” Fulfill Clients requirements ! Evaluated products: MapX, Geomedia Objects, Map Objects. Recommendation:Map Objects LightConsider Arc Objects (not released yet)Next step:Develop a common DHIS GIS - Make static and dynamic maps visualisation! - Focus on information quality - KISS Keep it small and simple - Be prepared to introduce advanced solution (e.g. Arc Internet Map Server)on a common HISP-server. Use commercial off-the-shelf (COTS) product. Two purposes:(a) Map data management – as a common function in the HISP community (b) Advanced analysis ArcView 8 is tested and approved as a powerful solution Next step: Appoint GIS ‘manager’ ! ”Maps in DHIS”Integrated map functionality in DHIS no runtime-licenses Internet GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

13. 3 in 1-Model 2. Advanced analysis 1. Data entry and reports Demographic, logistic, epidemiologic and other analysis using area overlay techniques, network analysis (e.g ArcView) DHIS with map component (e.g. MO): Integrated visualisation data/maps Web publication retrieval: HTML, XML, Web map server (E.g. Axiomap, ArcIMS + Arc Explorer) 3. Distribute & visualize GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

14. The Development Process • Existing solution is regarded as first iteration in a spiral model (link) • Our contribution is part of the second iteration – should be completed with • Pilot project • Running prototypes • Realistic data, use of information and CBA GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

15. (1a) Maps in DHIS • Preliminary Prototype developed in Access/VBA • Utilizes Map Object LT as a OCX-component • To be integrated in DHIS user interface GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

16. Standard Form in Access – with MO control object Standard MAP tools – should be customized to specific use (1b) Maps in DHIS GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

17. (1c) Maps in DHIS click IdentifyPHC GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

18. (1d) Maps in DHIS • Map Objects light, evaluation • Fits well into existing DHIS application • Well known development environment • Well proved • Cheap development environment • Run-time free licences • Not suitable for: • advanced analysis • establishment and management of base maps GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

19. (1e) Maps in DHIS • Next step • Establish a small development team with good VBA-skills • Prepare work shops • With DHIS-developers • With end users • Conduct a pilot project (to fulfill what we where supposed to achieve, see client’s challange) GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

20. (2a) Advanced GIS Advanced GIS serve two purposes: • MAP information management • Initial establishment of suitable base-maps and presentations • Analysis • prototypes that can serve as specifications forGIS in DHIS • Cooperation with Epidemiologists should be established to utilise advanced modeling and disease control GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

21. While Not pFeaturePoly Is Nothing 'Get the content of the two key fields idx = pFeaturePoly.Fields.FindField("VNAME") 'Knut strVname = pFeaturePoly.Value(idx) idx = pFeaturePoly.Fields.FindField("HABCODE") strHabcode = pFeaturePoly.Value(idx) Set pArea = pFeaturePoly.Shape 'Get a copy of the centroid point pArea.QueryCentroid pCentroidTemp Set pFeatureOut = pFClassOut.CreateFeature 'Store the centroid along with the two field values Set pFeatureOut.Shape = pCentroidTemp idx = pFeatureOut.Fields.FindField("HABCODE") pFeatureOut.Value(idx) = strHabcode idx = pFeatureOut.Fields.FindField("VNAME") pFeatureOut.Value(idx) = strVname pFeatureOut.Store Set pFeaturePoly = pFCursorPoly.NextFeature Wend '***************************************************************************** 'This script output the centroids of the first feature class feature (in position 0 in TOC) 'into the second feature class (in position 1 in TOC). 'The output feature class must be a ShapeFile. The first layer must be of type 'polygon and the second of type point 'Note : The Centroid is not always inside of the polygon. ' Uses the label point if you need a point always inside the polygon. '***************************************************************************** 'Verify if the second layer is of type point If Not pFClassOut.ShapeType = esriGeometryPoint Then MsgBox "Your second (in Position 1 in TOC)layer must be of type Point !" Exit Sub End If (2b) Advanced GIS '***************************************************************************** 'This script output the centroids of the first feature class feature (in position 0 in TOC) 'into the second feature class (in position 1 in TOC). 'The output feature class must be a ShapeFile. The first layer must be of type 'polygon and the second of type point 'Note : The Centroid is not always inside of the polygon. ' Uses the label point if you need a point always inside the polygon. '***************************************************************************** Private Sub GetPolygonCentroid() Dim pMxDoc As IMxDocument Set pMxDoc = ThisDocument 'Get the polygon feature Dim pFLayerPoly As IFeatureLayer Set pFLayerPoly = pMxDoc.FocusMap.Layer(0) Dim pFClassPoly As IFeatureClass Set pFClassPoly = pFLayerPoly.FeatureClass Dim pDatasetPoly As IDataset Set pDatasetPoly = pFClassPoly Dim pWorkSpacePoly As IWorkspace Set pWorkSpacePoly = pDatasetPoly.Workspace Dim pFCursorPoly As IFeatureCursor Set pFCursorPoly = pFClassPoly.Search(Nothing, True) Dim pFeaturePoly As IFeature Set pFeaturePoly = pFCursorPoly.NextFeature 'Verify if the first layer is of type polygon If Not pFClassPoly.ShapeType = esriGeometryPolygon Then MsgBox "Your first (in Position 0 in TOC)layer must be of type Polygon !" Exit Sub End If Dim pCentroidTemp As IPoint Dim pArea As IArea Dim pFLayerOut As IFeatureLayer Set pFLayerOut = pMxDoc.FocusMap.Layer(1) Dim pFClassOut As IFeatureClass Set pFClassOut = pFLayerOut.FeatureClass Dim pFeatureOut As IFeature Dim strVname As String 'Knut Dim strHabcode As String Dim idx As Long 'Knut 'Verify if the second layer is of type point If Not pFClassOut.ShapeType = esriGeometryPoint Then MsgBox "Your second (in Position 1 in TOC)layer must be of type Point !" Exit Sub End If 'Create an instance of point that will be reused for each polygon Set pCentroidTemp = New Point 'Loop over the polygon While Not pFeaturePoly Is Nothing 'Get the content of the two key fields idx = pFeaturePoly.Fields.FindField("VNAME") 'Knut strVname = pFeaturePoly.Value(idx) idx = pFeaturePoly.Fields.FindField("HABCODE") strHabcode = pFeaturePoly.Value(idx) Set pArea = pFeaturePoly.Shape 'Get a copy of the centroid point pArea.QueryCentroid pCentroidTemp Set pFeatureOut = pFClassOut.CreateFeature 'Store the centroid along with the two field values Set pFeatureOut.Shape = pCentroidTemp idx = pFeatureOut.Fields.FindField("HABCODE") pFeatureOut.Value(idx) = strHabcode idx = pFeatureOut.Fields.FindField("VNAME") pFeatureOut.Value(idx) = strVname pFeatureOut.Store Set pFeaturePoly = pFCursorPoly.NextFeature Wend End Sub Example: Generate centroid in ArcView GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

22. 2c ArcView • Flexible, Powefull, state-of-art GIS based on Arc Object • Dedicated applications can be developed –full licence (at the moment) GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

23. (2d) Advanced GIS Example: Edwin – Tanzania – is it published ? GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

24. (2e) Advanced GIS Recommendation & next step • ArcView • In the HISP community: • Recruit or train one AV-expert in each country • Establish an international GIS-’team’ responsible for standardization and application of GIS in HISP • Consider Arc Objects as an alternative to Map Objects GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

25. (3a) Internet • Based on maps produced with ArcView and by utilizing ArcExplorer how can maps be published and made availlable for the community ? • Utilizing Arc Internet Map Server is an advanced solution, Axio Map is an alternative – but according to KISS – we have looked into an even simpler solution: link GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

26. Example-1 GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

27. Example-2 GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

28. Recommendation • Detail design and constructuion of the 3G concept –(could be done as student projects next semester/year) • Each of the 3 levels can be done by seperate teams-> 3 teams for full development • VBA group, • Internet solutions group, • GIS advanced analysis group) GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02

29. Group Challenges • Multiple solutions led to confusion • Lack of sofware tools that were needed. • New concepts & Tool (eg. GIS, ArcView,…) • Lost contacts with Indian counterpart • Timing of communication with the client (too late and too little) GIS for the Health Information Systems Project in AP, India - MIS 472 ISD/ IN364 Team 1, 2003-05-02