Dataset Information

Role of geospatial mapping in the planning of HIV programs: A case study from Southern India.

ABSTRACT:

Abstract

Geographic information systems (GIS) tools can be used to understand the spatial distribution of local HIV epidemics but are often underutilized, especially in low-middle income countries. We present characteristics of an HIV epidemic within Hyderabad, a large city in southern India, as a case study to highlight the utility of such data in program planning.Cross-sectional sample recruited using respondent-driven sampling in a cluster-randomized trial.We analyzed data from 2 cross-sectional respondent-driven sampling surveys of MSM in Hyderabad, which were conducted as part of a cluster-randomized trial. All participants were tested for HIV and those positive underwent viral load quantification. ArcGIS was used to create heat maps of MSM distribution using self-reported postal code of residence and combined into larger zones containing at least 200 MSM.Postal code data was available for 661 MSM (66.2%) in the baseline and 978 MSM (97.8%) in the follow-up survey. The proportion of HIV-positive MSM (12.7-15.7%) and prevalence of virally suppressed persons (2.6-8.2%) increased between the 2 surveys. The distribution of all MSM, HIV-positive MSM, and HIV-viremic MSM differed significantly by geographic zone with several zones having higher numbers of HIV-positive and viremic individuals than would be expected based on the distribution of all MSM.The prevalence of HIV and HIV viremia among MSM differed by geographic zones within a city and evolved over time. Such data could be critical to improving program implementation efficiency by accurately targeting resources to population characteristics.

SUBMITTER: Prabhu S

PROVIDER: S-EPMC8389960 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Inadequate administrative health data, suboptimal public health infrastructure, rapid and unplanned urbanization, environmental degradation, and poor penetration of information technology make the tracking of health and well-being of populations and their social determinants in the developing countries challenging. Technology-integrated comprehensive surveillance platforms have the potential to overcome these gaps. OBJECTIVE:This paper provides methodological insights into establishing a geographic information system (GIS)-integrated, comprehensive surveillance platform in rural North India, a resource-constrained setting. METHODS:The International Clinical Epidemiology Network Trust International established a comprehensive SOMAARTH Demographic, Development, and Environmental Surveillance Site (DDESS) in rural Palwal, a district in Haryana, North India. The surveillance platform evolved by adopting four major steps: (1) site preparation, (2) data construction, (3) data quality assurance, and (4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geospatial data construction. Surveillance data architecture was built upon the geospatial land parcel datasets. Dedicated software (SOMAARTH-1) was developed for handling high volume of longitudinal datasets. The built infrastructure data pertaining to land use, water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, and demographic characteristics were constructed in a relational manner. RESULTS:The comprehensive surveillance platform encompassed a population of 0.2 million individuals residing in 51 villages over a land mass of 251.7 sq km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions, etc). All land parcels were assigned georeferenced location identification numbers to enable space and time monitoring. Subdivision of villages into sectors helped identify socially homogenous community clusters (418/676, 61.8%, sectors). Water and hygiene parameters of the whole area were mapped on the GIS platform and quantified. Risk of physical exposure to harmful environment (poor water and sanitation indicators) was significantly associated with the caste of individual household (P=.001), and the path was mediated through the socioeconomic status and density of waste spots (liquid and solid) of the sector in which these households were located. Ground-truthing for ascertaining the land parcel level accuracies, community involvement in mapping exercise, and identification of small habitations not recorded in the administrative data were key learnings. CONCLUSIONS:The SOMAARTH DDESS experience allowed us to document and explore dynamic relationships, associations, and pathways across multiple levels of the system (ie, individual, household, neighborhood, and village) through a geospatial interface. This could be used for characterization and monitoring of a wide range of proximal and distal determinants of health.

Project description:BackgroundCommunity health worker (CHW) programs are believed to be poorly coordinated, poorly integrated into national health systems, and lacking long-term support. Duplication of services, fragmentation, and resource limitations may have impeded the potential impact of CHWs for achieving HIV goals. This study assesses mediators of a more harmonized approach to implementing large-scale CHW programs for HIV in the context of complex health systems and multiple donors.Methods and findingsWe undertook four country case studies in Lesotho, Mozambique, South Africa, and Swaziland between August 2015 and May 2016. We conducted 60 semistructured interviews with donors, government officials, and expert observers involved in CHW programs delivering HIV services. Interviews were triangulated with published literature, country reports, national health plans, and policies. Data were analyzed based on 3 priority areas of harmonization (coordination, integration, and sustainability) and 5 components of a conceptual framework (the health issue, intervention, stakeholders, health system, and context) to assess facilitators and barriers to harmonization of CHW programs. CHWs supporting HIV programs were found to be highly fragmented and poorly integrated into national health systems. Stakeholders generally supported increasing harmonization, although they recognized several challenges and disadvantages to harmonization. Key facilitators to harmonization included (i) a large existing national CHW program and recognition of nongovernmental CHW programs, (ii) use of common incentives and training processes for CHWs, (iii) existence of an organizational structure dedicated to community health initiatives, and (iv) involvement of community leaders in decision-making. Key barriers included a wide range of stakeholders and lack of ownership and accountability of non-governmental CHW programs. Limitations of our study include subjectively selected case studies, our focus on decision-makers, and limited generalizability beyond the countries analyzed.ConclusionCHW programs for HIV in Southern Africa are fragmented, poorly integrated, and lack long-term support. We provide 5 policy recommendations to harmonize CHW programs in order to strengthen and sustain the role of CHWs in HIV service delivery.

Project description:ObjectiveTo explore the feasibility of producing small-area geospatial maps of chronic disease risk for use by clinical commissioning groups and public health teams.Study designCross-sectional geospatial analysis using routinely collected general practitioner electronic record data.Sample and settingTower Hamlets, an inner-city district of London, UK, characterised by high socioeconomic and ethnic diversity and high prevalence of non-communicable diseases.MethodsThe authors used type 2 diabetes as an example. The data set was drawn from electronic general practice records on all non-diabetic individuals aged 25-79 years in the district (n=163 275). The authors used a validated instrument, QDScore, to calculate 10-year risk of developing type 2 diabetes. Using specialist mapping software (ArcGIS), the authors produced visualisations of how these data varied by lower and middle super output area across the district. The authors enhanced these maps with information on examples of locality-based social determinants of health (population density, fast food outlets and green spaces). Data were piloted as three types of geospatial map (basic, heat and ring). The authors noted practical, technical and information governance challenges involved in producing the maps.ResultsUsable data were obtained on 96.2% of all records. One in 11 adults in our cohort was at 'high risk' of developing type 2 diabetes with a 20% or more 10-year risk. Small-area geospatial mapping illustrated 'hot spots' where up to 17.3% of all adults were at high risk of developing type 2 diabetes. Ring maps allowed visualisation of high risk for type 2 diabetes by locality alongside putative social determinants in the same locality. The task of downloading, cleaning and mapping data from electronic general practice records posed some technical challenges, and judgement was required to group data at an appropriate geographical level. Information governance issues were time consuming and required local and national consultation and agreement.ConclusionsProducing small-area geospatial maps of diabetes risk calculated from general practice electronic record data across a district-wide population was feasible but not straightforward. Geovisualisation of epidemiological and environmental data, made possible by interdisciplinary links between public health clinicians and human geographers, allows presentation of findings in a way that is both accessible and engaging, hence potentially of value to commissioners and policymakers. Impact studies are needed of how maps of chronic disease risk might be used in public health and urban planning.

Dataset Information

Role of geospatial mapping in the planning of HIV programs: A case study from Southern India.

Abstract

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure