Experience with Community-Based Mapping: Iringa, Tanzania

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Presented by Yohana Mapala, MEASURE Evaluation/Futures Group, at the July 2012 Workshop on Mapping Community Based
Global Health Programs for M&E.

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  • Tanzania is in the news!
  • Sample of 69 villages and mtaa was drawn from all seven district based on population size and high-risk areas
  • Community informants listed venues where people go to meet new sexual partners, Community informants were the village or street leaders who we believed that are familiar with the area and could provide us with insight to high risk behaviors
  • Venues named by most informants given highest priority for a visit and GPS coordinates recorded
  • Over 13 hundred community informants were interviewed from 136 sampled areas. We identified over 23 hundred unique venues and 15 hundred events
  • Of over 23 hundred venues identified only 484 were visited. 345 bars! Nearly three out of every four high-risk venues were bars.
  • High risk venues were found in every district of the region
  • We can display the venues in different ways – for example, how big they are
  • Here is the list of USG supported services in iringa
  • The site informants put colored stickers on the map to show the communities their clients came from.
  • Here we see clearly a large number of transmission hot spots, many with no condoms at the venue, that are uncovered by any VCT facility
  • Clear boundary of Njombe district (eliminate adjoining districts). REPLACE condom wholesalers with condom retailers
  • Clear boundary of Njombe district (eliminate adjoining districts). replace condom wholesalers with condom retailers
  • new map: radio instead of VCT
  • NEW MAP Overlay VCT and population – entire region
  • Experience with Community-Based Mapping: Iringa, Tanzania

    1. 1. Experience with Community- Based Mapping: Iringa, Tanzania Yohana Mapala MEASURE Evaluation/Tanzania 20 July 2012
    2. 2. The SettingIringa Region 16% adult HIV prevalence
    3. 3. The Issue  Where are the transmission hot spots?  Where are the prevention services?  Are the right services in the right places?
    4. 4. The Approach  Locate the transmission hot spots  Map the prevention services  Overlay transmission hot spots with service locations
    5. 5. The Approach  Locate the transmission hot spots
    6. 6. Locate the transmission hot spots: The Solution  Priorities for Local AIDS Control Efforts (PLACE) Rapid Assessment
    7. 7. What is PLACE?  Developed by MEASURE Evaluation  Asks where high-risk behaviors occur  Implemented in 20+ countries to date8
    8. 8. Locate the transmission hot spots: The Solution  Select sample villages and “mtaa”; add “special places”  Interview informants  Compile “hot spots”  Visit venues
    9. 9. The Sample  All 7 districts  69 villages and “mtaa” o probability of selection proportional to population size (Tanzania National Bureau of Statistics)  “Special Places” with presumed high risk o truck stops, plantations, mines, other10
    10. 10. Community Informants  9 to 12 adult informants per area  Village or street leaders  Knowledgeable about area  Listed venues/events where people go to meet new sexual partners.  Provided other insights into risk behaviors11
    11. 11. Informant interview
    12. 12. Venue Visits and Mapping  Compile list of venues and events  Visit the venues named by the most informants  Observe conditions at venue  Interview someone onsite  Record GPS coordinates13
    13. 13. Venue visit
    14. 14. Results: Community Informants  136 sampled areas  1,333 community informants interviewed o bar workers, street vendors, mechanics, farmers, health workers, community leaders, and others  Identified 2,314 unique venues  Identified 1,533 events o religious activities, funerals, auctions/market days, weddings15
    15. 15. Results: Venue Visits  Visited 484 most-commonly mentioned venues o 234 informal bars (48%) o 111 formal bars (23%)16
    16. 16. Venue Locations17
    17. 17. Venues by Number of Patrons 650 - 1500 350 - 650 145 - 350 62 - 145 5 - 6218
    18. 18. The Approach  Locate the transmission hot spots  Map the prevention services
    19. 19. Map the prevention sites: The Challenges  Include all USG-supported prevention sites
    20. 20. USG-Supported Services Condom distribution (wholesale, retail) VCT Mass media promotion Male circumcision HIV treatment*********************************************************************************************************************** Home based care PMTCT OVC
    21. 21. Map the prevention sites: The Challenges  Include all USG-supported prevention sites  Estimate their coverage areas  Many in remote rural areas  Limited budget and short time frame  Rainy season!
    22. 22. Map the prevention sites: The Solution Visit District Health Officer Visit Site • Take GPS reading Identify key • Photograph site informant • Explain paper maps • Pin-point where “most” clients come fromHybrid approach: direct (GPS) and paper-based mapping
    23. 23. Map the prevention sites: The Solution Visit District Health Officer Visit Site • Take GPS reading Identify key • Photograph site informant • Explain data collection • Pin-point where “most” clients come from Photograph the map
    24. 24. Map the prevention sites: The Solution Visit District Health Officer Visit Site • Take GPS reading Identify key • Photograph site informant • Explain data collection • Pin-point where “most” clients come from Photograph the map Integrate map into GIS
    25. 25. The Approach  Locate the transmission hot spots  Map the prevention services  Overlay service locations with transmission hot spots
    26. 26. Putting it all together: Hot spots and VCT coverage Hot spot, no condoms Hot spot, condoms unknown Hot spot, condoms seen Hot spot, condoms claimed VCT facility coverage
    27. 27. From the region to the district…
    28. 28. Putting it all together: Hot spots and condom distribution Hot spot, no condoms Hot spot, condoms unknown Hot spot, condoms seen Hot spot, condoms claimed Condom retail site
    29. 29. Putting it all together: Hot spots, condom distribution and VCT Hot spot, no condoms Hot spot, condoms unknown Hot spot, condoms seen Hot spot, condoms claimed VCT facility coverage Condom retail site
    30. 30. Putting it all together: Hot spots, VCT, and Radio Radio tower reach Hot spot, no condoms Hot spot, condoms unknown Hot spot, condoms seen Hot spot, condoms claimed VCT facility coverage Condom retail site
    31. 31. Putting it all together: Population reach of VCT Population Density (people/square km) 0-1 1-20 20-50 50+ VCT facility coverage
    32. 32. Now what? “Highlights” shown to 2 District Executive Directors (out of 7 in Region) Shared results with USAID Iringa Prevention Working Group Planned GIS/DDU workshop in August
    33. 33. MEASURE Evaluation is a MEASURE project funded by theU.S. Agency for International Development and implemented bythe Carolina Population Center at the University of North Carolinaat Chapel Hill in partnership with Futures Group International,ICF Macro, John Snow, Inc., Management Sciences for Health,and Tulane University. Views expressed in this presentation do notnecessarily reflect the views of USAID or the U.S. Government.MEASURE Evaluation is the USAID Global Health Bureausprimary vehicle for supporting improvements in monitoring andevaluation in population, health and nutrition worldwide.

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