application of gis in health sector india : future perspectives

1. application of gis in health sector india : future perspectives Dr. Madhulekha Bhattacharya* Professor & Head, Deptt of Community Health Acting Director National Institute of Health & Family Welfare New Delhi- 67 *Email : bhattacharya_madhulekha@yahoo.com / cha_nihfw@yahoo.com / www.nihfw.org

2. Objectives • To identify the data sets and use • To identify the enabling factors/constraints for wide spread use.

3. Data Required

4. HOW CAN WE USE THEM? DO WE HAVE THESE DATA SETS ?

5. Advantages Of GIS Technology In Health Sector • I. GIS technology improves researchers to organize and link • datasets. • II. This ability to link datasets can help public health practitioners • plan more cost-effective interventions. • III. Provides public health practitioners and researchers with • several new types of data and also build models. • IV. Maps to help decision makers & planners visualize and • understand a public health problem.

6. Where is it used in Public Health? Wherever spatial Data is needed • Emergency Services • Service delivery • Disease & risk factor mapping • Time trends • Environmental health • Natural Disasters • Education &Research • Medical Care • Modelling

7. Use in Emergency and Disasters Examples

8. GIS in Health Management Accessibility to OPD

9. GIS in Relief Operations People accessing the health facility 3.14 Sq Km Approx Population ~12,500

10. Service delivery & referral services Examples

12. “Want ambulance Real time users Voice Recognition Service provider Nearest location Hospital Map Database Location Service GPS Tracking route Other Network Services

13. What’s the Best Way to?… Source: ESRI, Understanding GIS, 1998. Example 8

14. Planning for infrastructure in Health Examples

15. Rural Health Service –planning for a PHC Taluka Savantvadi • Infrastructure • Primary Health Centre (PHC) • Medical Shops • Govt. Offices

16. Rural Health Service Taluka Savantvadi Villages Benefited Medical facility reaching 8 KM radius

17. Rural Health Service Taluka Savantvadi NEED of Primary Health Centre

18. Location Analysis : location and access to different health facilities can be displayed with zoom in feature to specify location. Chittoor District, Location and access analysis of PHCs

19. Disease /Risk factor mapping Examples

20. Health GIS for Administrators Cases reported for various diseases Visual Analysis is The NEED

21. Maps produced by GIS can show the comparison with two or • more data among the same or different databases. HIV Seroprevalence of Antenatal attendees with MSM, FSW & IDU, India 2008 (HIV Sentinel Surveillance, 2008-09)

22. District wise HIV % of ANC mothers whose husband unskilled workers(HSS-08)

23. National Highways and magnitude of Female Sex Workers HIV Seroprevalence of Southern States 2008, (HIV Sentinel Surveillance, 2008-09)

24. Map 1. Diabetic population as a percent of the total diabetic patient registry population by census tract. Medical center and primary care network locations are also noted.

25. 2. GIS-based prediction of malaria risk in Egypt (Hassan et al.,2003) • Methodology : • A georeferenced database for malaria management in Egypt was developed. • GIS database integrates epidemiologic, environmental and socioeconomic data. • The database was then built in ArcView GIS to generate maps. Malaria surveillance/control priorities in Egypt based on risk and vulnerability to transmission

26. In Iran GIS was used for detecting the clusters of four types of cancer. In another study, GIS was used for the development of a geostatistical model of skin cancer (Mesgari and Masoomi,2008) • Methodology : • Based on the gathering of the death records, the township was selected as the spatial unit of this study. • First, different geostatistical methods for the analysis and visualization of spatial distribution of cancer were tested and compared. • Finally, probability mapping was used for analyzing and visualizing the statistics of death caused by lung cancer. The result of probability mapping for lung cancer in Iran

27. GIS in Change Detection What has changed since…? Example 3

28. Age wise dist. of HIV prev. in STD cases

30. (GIS) tools can help expand ones understanding of disparities in health outcomes within a community : For example it was used to assess outcome disparities in patients with type 2 Diabetes and Hyperlipidemia (Geraghty et al.,2010) • Methodology : • The Chronic Disease Management Program maintains a registry of all patients with DM who receive • care in the UCDHS. • Patient data were obtained by querying the UCDHS’s electronic medical record. • Clinic addresses were geocodedwith 100% matching. • After that the study design of initial patient database and progressive exclusion criteria followed (flow • chart). Shaded boxes indicated numbers of patients who were excluded. • These data were then used to construct maps as demonstrations of the capabilities of this • GIS tool (e.g. Map 1&2) ).

31. Modeling • Modeling involves the integration of GIS with standard statistical and epidemiologic methods. • GIS can assist in generating data for input to epidemiologic models, displaying the results of statistical analysis, and modeling processes that occur over space. • Spatial interaction models analyze and predict the movements of people, information, and goods from place to place.The flows of people between rural areas, villages, cities, and countries are all forms of spatial interaction that are central to disease transmission.

32. Network Kernel Density Estimation Map 1: Planar Density of Study Area Map 3: Based on standard deviations from the mean below

33. Constraints • Lack of trained manpower • Lack of software • Lack of expertise • Lack of data • Lack for Policy for intersectoral / interministerial data sharing

34. VISION • To have a------: GIS HUB • At the district level with multi sectoral data sets, for analyzing and presenting the data to the District and health administrators for use and support functions.

35. Thank You