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A Geographic Information System for Leprosy Elimination (WHO LEP)(Source: http://www.who.int/lep/Monitoring_and_Evaluation/gis.htm) In a Leprosy Elimination Programme (LEP), a GIS system can help monitor the extent of MDT (multiple drug therapy) coverage at regional, district or even sub-district level. It can also provide a graphical analysis of epidemiological indicators over time, the spatial distribution and severity of the disease, identify pockets of high endemicity and indicate where there is a need to target extra resources. GIS Computerised mapping systems provide an excellent means of analysing epidemiological data, revealing trends, dependencies and inter-relationships that would otherwise remain hidden in data shown only in a tabular format. GIS can therefore be seen as a valuable management tool in the elimination programme, strengthening national, regional and sub-regional capacities in surveillance and monitoring. A network of resources and expertise in GIS development has now been established in over twenty countries, funded by WHO, UNICEF and USAID as well as by individual UN member states. Since 1992, GIS systems have been developed for the control of Schistosomiasis and Dracunculiasis and more recently, for the control of Onchocerciasis. Steps in Developing a GIS system for Leprosy EliminationThere are two basic elements to developing a GIS system for leprosy. The first, geographic element, involves the accurate recording of the location of each health facility in the country. A list must first be compiled of the health facilities with their full address, and if readily available, the geographical coordinates (expressed in terms of latitude and longitude position) of the health facilities. The inclusion of these coordinates uniquely identifies each health facility and enables its position to be digitally mapped on a computer with great precision. There are many potential sources for obtaining the geographical coordinates of health facilities: Ministry of Health or Planning, the Central Statistics Office , the Department of Land Surveys, University geographic departments, or other institutions. Where coordinates on each individual health facility may not be available, the coordinates of the nearest village may be. Coordinates of the villages would be sufficient to start development of the GIS database. If geographical coordinates for the health facilities are not available, it may be possible to approximate them by identifying their position on existing maps. These maps need to be sufficiently detailed to include village names and positions. They may be obtainable from the relevant ministry or Government department. Using these maps, LEP will endeavour to digitise the position of the health facilities on a computer. In some countries, it may be possible for unmapped health facilities (i.e. those for which the geographical coordinates are not known) to be determined by using Geographic Positioning System (GPS) technology. The second element to developing a GIS system for leprosy is recording the relevant baseline data for each health facility. The most relevant data required for leprosy is as follows:
Where can the computerised mapping be performed?LEP believes that most of the computerised mapping could be done at the national level if both the necessary facilities and trained personnel are available. LEP is willing to support any local initiative (either by Government or NGOs) to carry out these mapping procedures, including additional training in the use of GIS software and GPS operation where considered necessary. The GIS software currently being considered for this purpose is MapInfo, which can read Lotus 123, Excel spreadsheet files, dBase and FoxBASE database files and several others. Submission of Health Facility Data to LEPLEP would like to establish the GIS system in all endemic countries as soon as possible. The first step will be for National Programme Managers to compile a list of all health facilities in their respective countries, showing their location and what type of treatment is available for leprosy (if any). If readily available, the geographic coordinates for the health facilities should also be included in the list. One obvious advantage that a computerised list has over a paper based reporting system is the ease with which data can be updated, revised and analysed. Another is the speed at which it can be transmitted via E-mail or the Internet (where these facilities exist at the national level), and yet still retain its original format.. National Programme Managers are therefore strongly encouraged to compile the list on a computer. This computerised list should be sent to LEP by the end of March 1996 at the latest. Also, LEP would like to be informed whether the geographical coordinates for the country's health facilities (or villages) are available or not. Based on this feedback, LEP will keep the National Programme Manager informed about the next step to take in the process. |
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