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Mapping Maternal and Newborn Health in Malawi and Bangladesh
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Mapping Maternal and Newborn Health in Malawi and Bangladesh

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This presentation was given at the technical mash-up meeting on "Mapping for Maternal and Newborn Health", hosted by ICS Integrare and the University of Southampton, with the support of the Norwegian …

This presentation was given at the technical mash-up meeting on "Mapping for Maternal and Newborn Health", hosted by ICS Integrare and the University of Southampton, with the support of the Norwegian Agency for International Development (NORAD) in Southampton (UK), 11-12th March 2013. Further details are available here http://integrare.es/?cat=33
This presentation describes proposed research to determine the potential for mapping maternal and newborn mortality, access to maternal care, referral networks, and use of care at the district level in Malawi and Bangladesh. This would involve a desk review of existing data for Malawi and Bangladesh, resulting in mapping and modeling of MNH at one point in time (~2008-2010). The relationship between mortality and low access/low use of care would be analyzed using AccessMod and other geostatistical tools, producing policy recommendations for new facilities, improved transportation, and/or improved referral networks. Finally, in Malawi only, the project would conduct a feasibility assessment of creating a system that conducts “real-time” mapping of MNH. This would involve compiling facility records, health management information system (HMIS) data, and possible surveys in two districts.
By Allisyn Moran (USAID) and Reid Porter (University of Texas)

Published in: Health & Medicine

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  • The AidData Center for Development Policy at the University of Texas, in partnership with USAID, is developing an initiative to collect and map data on maternal care and mortality at the district level in Malawi, with a higher level study in Bangladesh and potentially Uganda. This effort is led by Drs. Elizabeth Fox and Allisyn Moran at the USAID Bureau for Global Health, and Drs. Catherine Weaver and Mike Findley at the AidData Center for Development Policy.
  • Ariel Pablos-Mendez, Asst. Admin. of the Bureau for Global Health, has set mapping of maternal mortality at the district level as a high priority for USAID to provide global leadership toward the effort to end preventable maternal mortality by 2035.
  • The initial study will assess the potential for this kind of district-level health mapping by exploring existing data sources, methodologies, and other applications of GIS in health modeling.
  • For this presentation, we’re going to focus on Malawi, which is our main study and represents our greatest need for input. We are still assessing data availability for Bangladesh, but we expect it to be a higher-level reviews with no primary data collection. Malawi was chosen due to its small size, data availability, and the existing relationship between the GoM and the PIs of ACDP.
  • The data sources for Bangladesh are still being assessed, but due to the lack of district-level reporting in DHS 2011, we will not be able to conduct as thorough a review as in Malawi.
  • These are the tools we have identified from previous studies as relevant to our analysis. We have not yet begun applying them to our available data but expect the process to be straightforward given their wide application elsewhere.
  • We have reached out to these people and organizations in order to access available data, as well as to discuss the feasibility of this project.
  • We are still assessing the feasibility of our pilot studies, so our objectives related to the MNH Mapping Network are: To identify opportunities to collaborate, share data, and build strategic relationships with other GIS and MNH actors in our target countries. To learn from the previous work of the organizations represented here today and adopt state-of-the-art practices, to avoid duplicating efforts. To integrate our project with this MNH Mapping Network and other MNH research from the outset.
  • Transcript

    • 1. Mapping Maternal and Newborn Health Proposed Study: Malawi & Bangladesh In Partnership With: The University of Texas at Austin AidData Center for Development Policy
    • 2. BACKGROUND• Maternal mortality has been identified as one of the farthest off-track MDG in many countries, partly due to poor data availability.• Call for better information at subnational level resonates with UN SG’s Every Woman, Every Child campaign, IERG, and the MNH Mapping Network.• Ending preventable child and maternal deaths are a priority focus for USAID
    • 3. OBJECTIVES• Determine the potential of mapping maternal and newborn mortality, access to maternal care, referral networks, and use of care at the district (admin 2) level• Use maps and analysis to explore the relationship between mortality and low access and use of care• Provide policy recommendations for new facilities, upgrades, improved transport, and/or improved referral networks with information on the impact of different interventions• Explore the possibility for a real-time mapping system at the district level in Malawi to inform local and national policymaking
    • 4. PROPOSED ACTIVITIES• Malawi (main study) – Desk review of existing data sources – Mapping and modeling of one point in time (~2008-10) – Primary data collection in-country – Feasibility study of “real time” MNH mapping• Bangladesh (limited secondary study) – Desk review – Mapping and modeling of one point in time (~2009-12)
    • 5. INDICATORS OF INTEREST• Maternal/newborn mortality and related indicators – Case fatality, complication rates, C-section rates• Maternal care service provision• Health facility access• Use of maternal care – Delivery in facilities, antenatal & postnatal care• Reported barriers to access• Contributing socioeconomic and environmental factors• Potentially unmet EmOC need
    • 6. POTENTIAL DATA SOURCES• Malawi – 2008 Census – 2010 DHS – 2010 Averting Maternal Death and Disability Assessment - AMDD – Malawi Spatial Data Portal (MASDAP): roads, land cover, etc. – HMIS, Health Surveillance Assistants, Facility records• Bangladesh – 2010 Bangladesh Maternal Mortality and Health Service Survey – 2009 MICS – icddr,b data – AMDD assessment
    • 7. POTENTIAL TOOLS & METHODS• AccessMod• Lives Saved Tool• Mapping location of maternal deaths vs. residence• Triangulation of data where possible – On maternal mortality, access times, mode of transport used, barriers to access, etc.
    • 8. POTENTIAL PARTNERS• Malawi – MoH and National Statistics Office officials – Clinton Health Access Initiative – College of Medicine – USAID Mission Office• Bangladesh – icddr,b – MoH and National Statistics Office – USAID Mission Office
    • 9. LINKAGES WITH MNH MAPPING NETWORK• Identify opportunities to collaborate with other GIS and MNH researchers in our target countries• Learn from previous work and current state of the art• Integrate project with broader MNH network from the outset
    • 10. ADDITIONAL USAID WORK IN THIS AREA• Mozambique – 2008 census and AMDD assessment• Maternal and newborn outcomes• Review of VA for role of infectious disease• Mapping key indicators (yet to be determine)• Working in collaboration with Measure Evaluation
    • 11. Questions? Thank you!