This document discusses the history and applications of geographic information systems (GIS) with a focus on its use in public health. It provides background on GIS, describing it as a set of tools for collecting, storing, manipulating, and displaying spatial data. The document outlines the history of GIS from early maps in the 1850s to the development of computer-based systems in the 1960s-1980s. It then discusses various uses of GIS in public health including disease mapping and surveillance, environmental health analysis, and health resource planning and accessibility analysis. Specific examples of GIS applications in Nepal are also mentioned.

1. Recent advance on
“Geographic Information system
and its application on health”
Swornim Bajracharya
Masters in Public Health
SPH & CM
BPKIHS

2. “Knowing where things are, and
why, is essential to rational decision
making.”
-Jack Dangermond
Esri President & Founder
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4. GIS = Geographic Information System
• A set of tools for Collecting Storing Manipulating Retrieving
Transforming and Display of Spatial Data from the Real
World
• Links databases and maps
• Manages information about places
Helps answer questions such as:
• Where is it?
• What else is nearby?
• Where is the highest concentration of ‘X’?
• Where can I find things with characteristic ‘Y’?
• Where is the closest ‘Z’ to my location?
The objective: to improve overall decision making
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5. Geographic Information Sytem
• GEOGRAPHIC implies that locations of the data items are
known, or can be calculated, in terms of Geographic
coordinates (Latitude, Longitude)
• INFORMATION implies that the data in a GIS are organized
to yield useful knowledge, often as colored maps and
images, but also as statistical graphics, tables, and various
on-screen responses to interactive queries.
• SYSTEM implies that a GIS is made up from several inter-
related and linked components with different functions.
• Thus, GIS have functional capabilities for data capture,
input, manipulation, transformation, visualization,
combinations, query, analysis, modelling and output.
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6. GIS
• A formal definition “A system for capturing,
storing, checking, integrating, manipulating,
analysing and displaying data which are
spatially referenced to the Earth. This is
normally considered to involve a spatially
referenced computer database and
appropriate applications software”
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7. History
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9. HISTORY(1)
• E. W. Gilbert's version (1958) of John Snow's
1855 map of the Soho cholera outbreak
showing the clusters of cholera cases in
the London epidemic of 1854
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10. History (2)
• Previously, one of the first applications of spatial analysis
in epidemiology is the 1832.This was one of the earliest successful
uses of a geographic methodology in epidemiology.
• The early 20th century saw the development of photozincography,
which allowed maps to be split into layers, for example one layer for
vegetation and another for water. This was particularly used for
printing contours
• 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) and was used to store, analyze, and
manipulate data collected for the Canada Land Inventory.
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11. History (3)
• By the late 1970s two public domain GIS systems
(MOSS and GRASS GIS) were in development.
• GRASS GIS- It can
handle raster, topological vector, image processing,
and graphic data.
• MOSS- open source GIS development - predating the
better known GRASS by 5 years. MOSS utilized a
polygon based data structure in which point, line, and
polygon features could all be stored in the same file
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12. History (4)
• By the early 1980s, M&S Computing along with Bentley
Systems Incorporated for the
1. CAD platform
2. Environmental Systems Research Institute (ESRI)
3. CARIS (Computer Aided Resource Information System)
4. MapInfo Corporation and
5. ERDAS (Earth Resource Data Analysis System)
Emerged as commercial vendors of GIS software,
successfully incorporating many of the CGIS features,
combining the first generation approach to separation of
spatial and attribute information with a second generation
approach to organizing attribute data into database
structures.
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13. History (5)
• In 1986, Mapping Display and Analysis System
(MIDAS), the first desktop GIS product emerged
for the DOS operating system.
• This was renamed in 1990 to MapInfo for
Windows when it was ported to the Microsoft
Windows platform.
• This began the process of moving GIS from the
research department into the business
environment.
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14. Principle
• Data Capture Data sources are mainly obtained from
manual digitization and scanning of aerial photographs,
paper maps, and existing digital data sets.
• Database Management and Update data security, data
integrity, and data storage and retrieval, and data
maintenance abilities
• Geographic Analysis The collected information is analyzed
and interpreted qualitatively and quantitatively.
• Preparing Result One of the most exciting aspects of GIS
technology is the variety of different ways in which the
information can be presented.
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15. Functions
• Data Capture The input of data into a GIS can be achieved through many
different methods of gathering. For example, aerial photography,
scanning, digitizing, GPS or global positioning system is just a few of the
ways a GIS user could obtain data.
• Data Storage Some data is stored such as a map in a drawer, while others,
such as digital data, can be as a hardcopy, stored on CD or hard drive.
• Data Manipulation The digital geographical data can be edited, this allows
for many attribute to be added, edited, or deleted to the specification of
the project.
• Query And Analysis GIS was used widely in decision making process for
the new commission districts. It uses population data to help establish an
equal representation of population to area for each district.
• Visualization This represents the ability to display data, maps and
information.
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16. Components
• Hardware Computer System, Scanner, Printer, Plotter, Flat Board
• Software GIS software in use are MapInfo, ARC/Info, AutoCAD Map,
etc. The software available can be said to be application specific.
• Data A GIS will integrate spatial data with other data resources and
can even use a DBMS, used by most organization to maintain their
data, to manage spatial data. Geographic data and related tabular
data can be collected in-house or purchased from a commercial
data provider.
• People GIS users range from technical specialists who design and
maintain.
• Method The map creation can either be automated raster to vector
creator or it can be manually victories using the scanned images.
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17. GIS- Program Flow
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18. Data Representation
• GIS data represents real world objects (e.g. roads, land
use, elevation, trees, waterways, etc.) There are 2
broad methods used to store data in GIS
1. Vector data model 2. Raster data model
(Vector) A coordinate-based data model that represents
geographic features as points, lines, and polygons.
1. Points Location of Wells, Schools, or Points of Interest
2. Lines / Polylines Road Centerlines, Rivers, Trails, or
Streets
3. Polygons Boundary of Cities, Lakes, or Forests
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19. Data representation
• (Raster) A spatial data model that defines
space as an array of equally sized cells
arranged in rows and columns.
• Each cell contains an attribute value and
location coordinates.
• Raster as Satellite Imagery Raster or as
Elevation Surface
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20. Example
Cross Country Movement
• CCM (Cross Country
Movement) Analysis
allows the user to
model the cost (e.g.
time) it would take for
a given object to travel
from point A to Point B
given the difficulty of
the terrain.
• For example, if a tank
had to travel from point
A to point B and knew
how fast it could travel
on certain road types,
soil types, and slopes,
could model the travel
cost.
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21. Overlaying Data Layers
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In a GIS, each layer
represents one type
of data.
The layers are
overlain on top of
each other and are
geographically
aligned.

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23. GIS in Public Health
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24. GIS and Public Health
• Researchers can easily use GIS to answer “Where?”
questions and in many cases it can provide answers to
other questions related to public health because maps
created via GIS can help to show patterns between
things such as disease starting points, risk factors and
sources of pollution.
• Incidence and prevalence are two more important
foundations for using GIS in public health applications.
• GIS can allow researchers and health officials to see the
distribution of deadly diseases and possibly find a
source.
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25. GIS and Public health
• Once these foundations are examined by
researchers Esri offers four steps to follow for
GIS and public health projects.
• Assessment
• Policy Development
• Operational awareness
• Assurance
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26. Recent advances in application of
GIS on Health
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27. GIS in Health
• The instruments supporting this field include geographic
information systems (GIS), disease surveillance, big data, and
analytical approaches like the Geographical Analysis Machine
(GAM), Dynamic Continuous Area Space Time Analysis (DYCAST),
cellular automata, agent-based modeling, spatial statistics and self-
organizing maps.
• One of the first notable medical GIS software is referred to as the
Geographic Analysis Machine (GAM), developed in 1987 by
Openshaw and his colleages and used to analyze locations of
clusters of Leukemia in 1983. This system “contained 4 major
components:
(1) a spatial hypothesis generator;
(2) a significance assessment procedure;
(3) a GIS to handle spatial data retrieval requests; and
(4) a geographical display and post map processing system”
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28. GIS in Health
• Space-time representation is one of the current frontiers in the evolution
of GIS, and is considered by many to be an essential component of the
spatial analysis of disease patterns.
• Kistemann, Dangendorf, and Schweikart emphasize the importance of
integrating spatial and temporal elements in their definition of
geographical epidemiology as “the collection and analysis of spatial
patterns of disease appearance and disease-specific deaths, taking into
consideration the social, economic, ecological and demographic
prerequisites of space and time”
• Dr. Peuquet, Professor of Geography and Associate Director of GeoVISTA
Center at Pennsylvania State University, described the importance of
adding a time component to geographical data: “ Inclusion of the temporal
element in the data is required, in everyday life, as well as in scientific
study, in order to derive cause-and-effect relationships and ultimately an
understanding of nature and structure of various elements in the world
around us”
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29. GIS in Health
• One notable example of the innovative application of
space-time representation to disease monitoring is the
dynamic continuous-area space-time (DYCAST) system,
which was successfully used to monitor and predict the
spread of West Nile virus in New York City.
• One of the current advancements in the fields of Medical
GIS is coming from our increasing ability to collect and
analyze mass amounts of information, a phenomenon
known as Big Data. “Big Data refers to datasets whose size
is beyond the ability of typical database software tools to
capture, store, manage, and analyze”
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30. Uses in Health
• GIS in Mapping: Google map, Bing map, Yahoo map are the best
example for web based GIS mapping solution
• Accident Analysis and Hot Spot Analysis: By identifying the
accident locations, remedial measures can be planned by the
district administrations to minimize the accidents in different parts
of the world. Rerouting design is also very convenient using GIS.
• Environmental Impact Analysis: The EIA can be carried out
efficiently by the help of GIS, by integrating various GIS layers,
assessment of natural features can be performed
• Disaster Management and Mitigation: GIS can help with risk
management and analysis by displaying which areas are likely to be
prone to natural or man-made disasters. When such disasters are
identified, preventive measures can be developed.
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31. Uses
• Landslide Hazard Zonation using GIS: Landslide hazard
zonation is the process of ranking different parts of an area
according to the degrees of actual or potential hazard from
landslides.
 The evaluation of landslide hazard is a complex task. It has
become possible to efficiently collect, manipulate and
integrate a variety of spatial data such as geological,
structural, surface cover and slope characteristics of an
area, which can be used for hazard zonation.
 The entire above said layer can well integrate using GIS and
weighted analysis is also helpful to find Landslide prone
area. By the help of GIS we can do risk assessment and can
reduce the losses of life and property.
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32. Uses
• Worldwide Earthquake Information System: A GIS based
user interface system for querying on earthquake catalogue
will be of great help to the earthquake engineers and
seismologists in understanding the behavior pattern of
earthquake in spatial and temporal domain.
• Pest Control and Management: Pest control helps in the
agricultural production: Increasing in the rate of pest and
weeds can lead to decrease in the crop production.
 Therefore GIS plays an important role to map out infested
areas. This leads in the development of weed and pest
management plan.
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33. Public Health
• Besides, GIS can contribute to public health in many ways
due to the fact that they can provide information on many
issues and support correctly the decision making process.
• They can provide information regarding the distribution of
health services. Thus, any growing disparities might be
eliminated. Also, policy-makers would make right decisions.
• Health professionals can easily identify the difficulties and
disparities regarding the accessibility to health services;
and so, they are able to cope with the current situation.
• GIS provides the cost effective tool for evaluating
interventions and policies potentially affecting health
outcomes.
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34. Public Health
• Public health services, diseases, and any information regarding
health can be displayed on a map and correlated amongst many
pieces of information such as environmental data, elements of
health concern and social information.
• It can be understand the complex spatial temporal relationship
between environmental pollution and disease, and identifying
exposures to environmental hazards. GIS can significantly add value
to environmental and public health data.
• Another advance in GIS is its relationship with GPS systems- GIS
provides realistic, on the ground data that GPS uses to inform its
users of where they are and things to look for around them.
• Generally, the planning of health and social care is of major
importance since it is a fundamental issue.
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35. Public Health
• At the dawn of the 21st century, in the midst of remodeling the
entire health care system, the use of new approaches relating to
health issues may become useful tools for the providers of these
services.
• The use of GIS so as public health issues to be solved has grown
exponentially. Those systems have been vital to both the
assessment and treatment of health problems that relate to
different areas of land.
• A Geographic Information System can play an important role as
regards the surveillance, management and analysis of diseases.
There seem to be important tools for analysis and visualization of
epidemiological data.
• Furthermore, trends and correlations would be difficult to be
understood with traditional ways of processing and imaging of
these data.
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36. • HealthMap
(http://www.who.int/csr/mapping/en/) is
a joint WHO/UNICEF GIS Programme
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40. In Nepal
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41. GIS
• 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.
• 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, HealthGIS and need for
integration of information systems.
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42. Some of its uses in Nepal
• Nepal GIS Society is dedicated since 1995 For ..........
 Professional Networking
 Awareness and advocacy
 Applied and empirical research
 GIS and GPS training
 Consultancy services
• Introducing GIS to strengthen immunization coverage
• Urban area health clinic/ immunization clinic mapping
• Identify hard to reach areas
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44. In Nepal
• Programme 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,
 to strengthen capacity of government and IPD field
network in analysis/management of VPDs and routine
immunization data,
 to strengthen VPD surveillance and to support in
achieving goals of immunization programme of
DoHS/MoH.
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47. Limitations
• GIS technology might be considered as expensive software.
• GIS Center: lacks coordination, networking and standardization of
the activities, found in parts and patches. There is lacking of
National Spatial Data Center (NSDC), no National Spatial Data
Infrastructure (NSDI), and no standardization about the ontology of
geographical objects by which nation has hard time to transform
from the analog to digital information technology.
• Hard time to get in consensus
• No national level guidelines
• Movement of people – regional and countrywide
• The results will only be as accurate as the data that they come from
• They do not come "off the shelf," which means that they must be
assembled and constructed to a user design
• Violation of privacy
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48. Conclusion
• Public health is an application area where GIS has proven to be a reliable
method for better future planning towards one of the most important
object: better public health
• The demand for GIS in the health field parallels the advancements in
disease control.
• It is an invaluable approach, which identifies and maps medically
vulnerable populations, health outcomes, risk factors and the
relationships between them.
• The capacity of GIS to link disease information with environmental and
spatial data makes it an asset in the progression of worldwide healthcare.
• Continuing innovations in GIS and Big Data make this an exciting time for
medical GIS, and it will be interesting to witness how new technologies,
analytical techniques, and data sources will shape the future of the
discipline
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49. References
• WHO, IPD, Developing GIS-based tools and system to
promote “the use of data”
• Recent Advances in GIS Technology,
https://www.gislounge.com/recent-advances-gis-
technology/
• Pubmed,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315644/
• Geographic Information Systems and Environmental
Health: Incorporating Esri Technology and Services,
http://www.esri.com/library/whitepapers/pdfs/gis_and_en
v_health.pdf
• CDC, https://www.gislounge.com/overview-public-health-
gis/
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50. • Nepal’s Health innovation
https://bibekjournal.wordpress.com/tag/nepal-gis-health-map
• DOHS/Information system/GIS
• CROE polio program/CHD/society for conservation GIS-SGIS Nepal
• ESRI
• Gromley EK, McLafferty SL. GIS and Public Health. New York:
Guilford Press; 2002.
• McLafferty SL. GIS and health care. Annual Review of Public
Health. 2003;24(1):25–42. [PubMed]
• SAS. What Is Big Data? 2013. [Accessed May 22, 2013]. Available
at http://www.sas.com/big-data.
• Zia K, Farrahi K, Riener A, Ferscha A. An agent-based parallel geo-
simulation of urban mobility during city-scale
evacuation. Simulation. 2013:1–31.
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51. THANK
YOU
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