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Citation Information

Type Journal Article - Tropical Medicine & International Health
Title Local Use of Geographic Information Systems to Improve Data Utilisation and Health Services: Mapping Caesarean Section Coverage in Rural Rwanda
Author(s)
Volume 18
Issue 1
Publication (Day/Month/Year) 2013
Page numbers 18-26
URL http://www.ncbi.nlm.nih.gov/pubmed/23279379
Abstract
Objectives: To show the utility of combining routinely collected data with geographic location using a Geographic Information System (GIS) in order to facilitate a data-driven approach to identifying potential gaps in access to emergency obstetric care within a rural Rwandan health district.

Methods: Total expected births in 2009 at sub-district levels were estimated using community health worker collected population data. Clinical data were extracted from birth registries at eight health centres (HCs) and the district hospital (DH). C-section rates as a proportion of total expected births were mapped by cell. Peri-partum foetal mortality rates per facility-based births, as well as the rate of uterine rupture as an indication for C-section, were compared between areas of low and high C-section rates.

Results: The lowest C-section rates were found in the more remote part of the hospital catchment area. The sector with significantly lower C-section rates had significantly higher facility-based peri-partum foetal mortality and incidence of uterine rupture than the sector with the highest C-section rates (P < 0.034).

Conclusions: This simple approach for geographic monitoring and evaluation leveraging existing health service and GIS data facilitated evidence-based decision making and represents a feasible approach to further strengthen local data-driven decisions for resource allocation and quality improvement.

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