Presentation on GIS in public health

1. Recent Advance Presentation on
Geographic Information
System in Public Health
Presentation By:
Bikram Adhikari (136)
MPH-2018
School of Public Health and Community Medicine

2. Overview
• Introduction
• History of GIS in relation to Health
• Applications of GIS in public health
• Challenges
• GIS in Nepal
• Conclusion
4/26/2019 2

3. Basic terminologies
• GIS data:
• Spatial data:
• It is information about a physical object that can be represented by numerical
values in a geographic coordinate system.
• It exist in 2 forms:
• Vector—Point, line, Polyline, Polygon
• Raster--- Grid, Image
• Non-spatial:
• Attribute
4/26/2019 3

4. Introduction
4/26/2019 4

5. Introduction
• A geographical information system (GIS) is a computer system for
capturing, storing, checking, integrating, manipulating, analyzing and
displaying data related to positions on the Earth's surface.
• It is thus a way of linking databases with maps, to display information,
perform spatial analyses or develop and apply spatial models.
• The phrase "geographic information systems" was first used in the
1960s to refer to a computerized system for asking questions of maps
showing current and potential land use in Canada
4/26/2019 5

6. Components of GIS
• Hardware
• Software
• Data
• People
• Method
4/26/2019 6

7. GIS Mapping Software
4/26/2019 7

8. GIS Mapping Software
4/26/2019 8

9. GIS Function
• Capture data
• Data storage
• Data manipulation
• Query and data analysis
• Data visualization
4/26/2019 9

10. What can we do with GIS
• Mapping where things are
• Mapping quantities
• Mapping densities
• Finding what is inside.
• Finding what is nearby
• Mapping change
4/26/2019 10

11. History
4/26/2019 11

12. History
• In 1848, Dr. Thomas Shapter published a dot density map of 1,100
deaths from cholera in Exeter that occurred between 1832 and 1834,
using different symbols for deaths occurring in different years.
4/26/2019 12

13. History
• Public health efforts have been based on analysis and use of spatial
data for many years. Dr. John Snow (physician), often credited as the
father of epidemiology, is arguably the most famous of those
examples
4/26/2019 13

14. History
• The year 1960 saw the development of the world's first true
operational GIS in Ottawa, Ontario, Canada by the federal
Department of Forestry and Rural Development.
• Developed by Dr. Roger Tomlinson, it was called the Canada
Geographic Information System (CGIS)
• It was used to store, analyze, and manipulate data collected for the
Canada Land Inventory
4/26/2019 14

15. Father of GIS and World GIS day
• Father of GIS: Dr. Roger Tomlinson (1933-2014)
• World GIS day: 13th November
4/26/2019 15

16. GIS and Public Health
• Geographic Information Systems (GIS) play a major role in health care,
surveillance of infectious diseases, and mapping and monitoring of
the spatial and temporal distributions of vectors of infection.
• GIS combine sophisticated algorithms, spatial analysis, geo-statistics
and modelling, making GIS technology a powerful tool for the
prediction of disease patterns and parasite ecology associations
4/26/2019 16

17. Application of GIS in Public Heath
• Human Health Decision-Making
• Disease surveillance and early warning systems
• Use of GIS in vaccine efficacy trial
• GIS In The Epidemiology And Control Of Helminthiase
• Cluster random sampling and data collection
• Pandemic Planning And Prediction
• GIS and Mental health
• Geographic information systems and health services
• The application of GIS in environmental health management
4/26/2019 17

18. Application of GIS in Public Health
1. Human Health Decision-Making
• The combination of GIS and Human Health applications with the
decision-making processes as defined in Anthony’s Model.
4/26/2019 18

19. 4/26/2019 19

20. Application of GIS in Public Heath
2. Disease surveillance and early warning systems
• Spatial observations of environmental factors such as rainfall, land
use, surface temperatures, oceans and land cover have a direct
epidemiological impact on the transmission of diseases.
• Consequently, the ability to apply GIS techniques to disease
surveillance has opened up a world of possibilities in creating early-
warning systems for emerging and re-emerging diseases
4/26/2019 20

21. Application of GIS in Public Heath
• The incorporation of a GIS-based spatial decision support system (SDSS)
into the surveillance response system in the South Pacific is a major
achievement for Vanuatu and Solomon Islands.
• The SDSS is designed to automatically locate and map confirmed malaria
cases, to classify active foci of infection, and to guide targeted
interventions.
• With technical assistance provided by the Pacific Malaria Initiative Support
Centre (PacMISC) and WHO, local authorities were able to build custom
applications into the existing provincial SDSS used in previously identified
elimination provinces, to support general topographic mapping, geographic
reconnaissance and vector control intervention management.
4/26/2019 21

22. Application of GIS in Public Health
• One noteworthy example of how GIS has been applied to other
infectious diseases is the World Health Organization (WHO)’s
DengueNet,
• It is a centralized data management system that includes a database
and GIS for the global epidemiological and virological surveillance of
dengue fever (DF) and dengue haemorrhagic fever (DHF).
• This web-based system makes available to users a standard platform
where current surveillance data on the incidence and trends of
dengue and DHF are shared.
4/26/2019 22

23. Application of GIS in Public Heath
3. Use of GIS in vaccine efficacy trial
1. Planning and logistic support for trial
• Vaccine trial requires- area with high disease burden, adequate healthcare
centers to detect the target disease, and a system for the transportation of
the vaccines
• In cluster randomized trials, it is necessary to :
• to define appropriate geographical clusters
• understand the population size
• the disease burden at the cluster level.
(Between-cluster heterogeneity in disease burden may lead to bias in the estimate of
protection offered by the vaccine)
4/26/2019 23

24. • GIS helps in
• investigating the spatial pattern of the disease burden
• Finding any significant heterogeneity in this indicator can be addressed during
data analysis.
• Defining cluster for vaccination
• If vaccines are administered in the community, the daily vaccine
requirement has to be predicted accurately, to allow shipping of
the correct number of vaccine doses within cold chain GIS
• GIS was used to estimate the distance between specimen-collection
centers and the center for specimen storage (Vietnam)
4/26/2019 24

25. Application of GIS in Public Heath
3. Use of GIS in vaccine efficacy trial
2. Trial management
• Refusals and absentees are a common concern in vaccine trials.
• The identification of areas with relative high frequencies of non-compliance,
during a vaccine campaign, can help investigators to target such areas for
sensitization prior to the next day / round of vaccination and/or increased
volunteer deployment during the next vaccinations.
• GIS can be used
• To find geography wise prevalence of non-compliance
• Example: In Vietnam,GIS helped identification and targeting of the areas that
were worst affected by non-compliance.
4/26/2019 25

26. 4. GIS In The Epidemiology And Control Of Helminthiase
• The effective control of helminth infections in humans requires
reliable estimates of the geographical distributions of such infections
and the sizes of populations requiring an intervention.
• The relationship and associated uncertainty between infection
outcomes and covariates are estimated and the model is used to
predict the outcome at unsampled locations
4/26/2019 26

27. • In West Africa, a regional multinomial model was built to identify
areas with high prevalence of high-intensity S. haematobium infection
• Predicted prevalence maps, including those derived from MBG, can
be multiplied by electronic population-density maps to determine the
numbers of individuals infected in each location.
4/26/2019 27

28. 5. Pandemic Planning And Prediction
• Pandemics are intrinsically geographical, with infection often moving
rapidly from one place to another and spanning large distances in
doing so.
• The planning required to prepare for, or intervene in, pandemics
involves an understanding of the spatial patterns of the transmission
and spread of the pathogen involved.
4/26/2019 28

29. 4/26/2019 29

30. 4/26/2019 30

31. • 6. GIS and Mental health
• Mental disorders appear to spread in all countries, societies and
nations, regardless of socioeconomic level of the population.
• Mental illness is typically associated with age.
• Mental illnesses are quite intertwined with environmental changes or
disasters and changes in land use such as urbanization
4/26/2019 32

32. • It is expected that the geographical representation of this data will
serve as a valuable tool for health professionals both in treating and
preventing mental illness.
• GIS is used to assess accessibility to mental health services and
general health services.
• GIS can analyze and portray accurately the distribution of mental
health services and they could explain the reasons why the
accessibility in healthcare services is affected.
4/26/2019 33

33. 4/26/2019 34

34. 4/26/2019 35

35. 7. Geographic information systems and health services
• In general, the fields of application of GIS could be applied to strategic
planning, research, evaluation, preparedness for emergency
situations and the availability and location of health care services
• Geographic Information Systems provide us with the exact location of
specific medical equipment and how somebody may gain the fastest
access to it. It is important an insurance institution, when it is
requested by the insured, know the nearby location where the
insured could gain access to a CT scanner.
4/26/2019 36

36. 8. The application of GIS in environmental health management
• The environmental impacts on human health are significant.
• GIS could be used in studying cardiovascular health problems,
including deaths due to heart disease and stroke. These deaths can be
linked to gaseous pollutants, particularly air pollution. GIS can display
these gaseous and particulate matter types and their uniform
dispersion and transmission
4/26/2019 37

37. 4/26/2019 38

38. 4/26/2019 39

39. Application of GIS in Public Heath
9. Useful in Cluster random sampling and data collection
4/26/2019 40

40. 4/26/2019 41

41. 4/26/2019 42

42. 4/26/2019 43

43. 4/26/2019 44

44. 4/26/2019 45

45. Application of GIS in public health and
medicine
• Travel Medicine
• Environmental Health decision
• Mapping of Health services Providers
• Population growth
• Geographic access to Health Services
• Geographic Epidemiology
4/26/2019 46

46. 4/26/2019 47

47. 4/26/2019 48

48. Application of GIS in public health and
medicine
• Disaster management and mitigation
• Environment Impact analysis
• Accident analysis and hot spot analysis
4/26/2019 49

49. GIS, Public health and Challenges
4/26/2019 50

50. Challenges
• Limited access to GIS infrastructure
• Limited technical capacity and experience
• Limited data availability and analysis capacity
• Privacy issues
4/26/2019 51

51. History-GIS in Nepal
• The National Remote Sensing Center was the pioneer organization
to establish the history of digital spatial database of Nepal which was
established with the financial and technical support of USAID in
1979.
• After the Ninth Five Year Plan (1995-2002) the Government of Nepal
has been incorporating the use of GIS and RS technology for the
preparation of land use map of the country as a key planning aid.
4/26/2019 52

52. • Nepal GIS society is dedicated since 1995 for
• Applied and empirical research
• GIS and GPS training
• Introduction of GIS to strengthen immunization coverage
• Urban Area clinic/ Immunization clinic mapping
• Identification of hard to reach area.
4/26/2019 53

53. GIS in Nepal
• GIS has been incepted and in the process of institutionalize in the
health system.
• This is guided by NHSP, periodic Development Plans, Health Sector
Information System-National Strategy(HSIS-NS) and information,
Communication and Technology Policy of the Government of Nepal.
• This adoption is also reinforced by e-health, Health GIS and need for
integration of information systems.
4/26/2019 54

54. GIS in Nepal
• Health Facility Mapping Survey(HFMS) has been carried out in 57
districts with technical and financial support from WHO and further
processing for remaining 18 districts is going on.
• The completion of this survey is expected to result in geographic
feature embedded planning, monitoring and evaluation in the health
system.
4/26/2019 55

55. WHO--Developing GIS-based tools and system
to promote “the use of data”
• Program for Immunization Preventable Disease (IPD) has recently
invested in developing GIS-based tools and system to
 Promote “the use of data” i.e. collection, analysis, interpretation,
and review of data as part of a decision-making processes,
 Strengthen capacity of government and IPD field network in
analysis/management of VPDs and routine immunization data,
 Strengthen VPD surveillance and
 Support in achieving goals of immunization program of DoHS/MoHP.
4/26/2019 56

56. • Vaccine Preventable Disease Mapping System (VPDMS)
Vaccine Preventable Disease Mapping System (VPDMS) is a web GIS
based system that allows the users effectively and efficiently to
manage and analyze epidemiological data related to some key vaccine
preventable diseases.
• VPDMS is accessible via a normal web browser without requiring any
installation in the client side.
4/26/2019 57

57. • The existing system has four major functionalities which are data
input, visualization, report generation and access control, elaborated
as follows
• Use of existing IPD data reporting mechanism as data input for case-
based surveillance data on weekly basis, district level immunization
coverage and population data in yearly basis.
• Diseases data visualization
• Generating standardized reports
• Access to IPD network and government counterparts
4/26/2019 58

58. • GIS Based Tool for Districts
The GIS based tool is designed by the Program for Immunization
Preventable Diseases (IPD), World Health Organization, Country Office for
Nepal, to assist districts to plan surveillance and immunization activities.
The following functionalities are incorporated in the Tool.
• Viewing geographic accessibility to health facility
• Preparing administrative boundary maps up to ward level
• Viewing immunization booth location and session information at ward level
• Accessing geo-spatial information dynamically in the field (offline)
4/26/2019 59

59. • Excel-based mapping Tool
The tool is designed in such a way that a non-GIS person can easily
prepare a map of immunization coverage by antigen, just by typing in
the data values to generate map in MS Excel.
• The tool can be further modified to create VDC level mapping
template. The functionalities are
• Create district level map of immunization coverage of all antigen.
• Modify the template to create a VDC level map of immunization
coverage
4/26/2019 60

60. GIS is being used in the field of public health
4/26/2019 61

61. Conclusion
• Public health is an application area where GIS has proven to be
reliable method for better future planning towards one of the most
important objective: Better Public health
• Despite the challenges, GIS use in the public health is increasing
world wide and in Nepal.
• As a public health students and professionals, its time to integrate GIS
in public health research or project. Result obtained may be help to
develop relevant policies
4/26/2019 62

62. References
• https://www.gislounge.com/overview-public-health-gis/
• Zhang W, Chen Q, McCubbin H, McCubbin L, Foley S. Predictors of
mental and physical health: Individual and neighborhood levels of
education, social well-being, and ethnicity. Health & Place.
2011;17:238–247.
• Fradelos EC, Papathanasiou IV, Mitsi D, Tsaras K, Kleisiaris CF,
Kourkouta L. Health Based Geographic Information Systems (GIS) and
their Applications. Acta Inform Med. 2014;22(6):402–405.
doi:10.5455/aim.2014.22.402-405
• http://oneclout.com/basic-concepts-of-gis-an-introduction/
4/26/2019 63

63. • Lisabeth LD, Escobar JD, Dvonch JT, et al. Ambient air pollution and
risk for ischemic stroke and transient ischemic attack. Ann Neurol.
2008;64(1):53–59. doi:10.1002/ana.21403
• https://www.negiss.org.np/
4/26/2019 64

64. 4/26/2019 65