Organised Editing/Activities/Geographical access to care - Mapping in vatovavy region, Madagascar

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Geographical access to care - Mapping in vatovavy region, Madagascar

Introduction

Access to healthcare in rural areas of developing countries remains extremely limited, resulting in high mortality rates, particularly among pregnant women and children. This problem is also present in the districts of Ifanadiana, Mananjary and Nosy-Varika, located in the southeastern of Madagascar in Vatovavy region. This region suffers from poverty and major geographical barriers that considerably impacted access to healthcare facilities. Since 2014, the NGO Pivot has been working in partnership with the Ministry of Health to strengthen the public health system in the Ifanadiana district, to create a health district model for the country. Although Pivot's intervention has led to a significant increase in essential care coverage and a three-fold increase in the use of health services, these benefits remain limited for the most isolated populations. In order to understand the specific care itineraries and the travel time required for each community to reach the nearest health center, this study was developed to address the health needs of these remote populations, using the Ifanadiana district as a pilot project.

In order to extend their intervention area in region level, Pivot would like to scale up the same project in two news districts. This activity will help assess populations' travel time to public health facilities and understand geographic barriers for accessing care in Vatovavy region, South Eastern of Madagascar. As part of this activity, Pivot are requesting assistance in creating a base map of all villages, buildings, footpaths, roads, waterways and rice fields in the district of Mananjary and Nosy-Varika. The final maps will primarily serve as a basis for assessing the travel times of residents from each household to the nearest health center and for understanding the main geographical barriers for each community throughout the year. This will help in designing and prioritizing interventions focused on malnutrition, community health program and patient’s referral to these remote populations.

Approach

Our approach to the project is as follows:

  • We recruited 4 mappers with experience on mapping and geomatics, some of which had previously mapped in OSM.
  • At the beginning of the project, the mappers received a series of on-hand training sessions with clear guidelines on OSM mapping
  • We use GeoHealth Tasking Manager, a program developed by IRD based on open access code adapted from the Tasking Manager of the Humanitarian OpenStreetMap Team (HOT)
  • Each district is divided into 3 or 5 projects and every project is divided into tasks of 5.22 km².
  • Mapping is done using JOSM / ID editor
  • We use the Bing imagery as the imagery background
  • Mappers open tasks in the Tasking Manager and map missing buildings, residential areas, rice fields, footpaths, roads and waterways (stream and river)
  • All individual buildings are mapped, whether isolated or as part of a residential area.
  • Settlements with more than four (4) buildings are mapped as residential areas
  • All types of roads and small footpaths that local populations use to travel around rural areas are mapped. We refer to Highway Tag Africa in the OSM wiki for guidance on appropriate tagging of highways.
  • We refer to Waterways in the OSM wiki for guidance on appropriate tagging of waterways
  • In terms of land use, we only map rice fields, but not other types of land use
  • Data quality is ensured via a multi-tiered validation process (see data quality section)

Data quality

To ensure data quality, all four mappers hired for our project have university training in geography and geomatics, most at the masters’ level, and some had previous experience in OSM mapping. Several actions help ensure the quality of their work:

  • All mappers received an initial training on OSM mapping, the use of JOSM, and the Tasking manager interface
  • All mappers work together in the same space, which allows them to interact and solve problems.
  • At the end of each task, the mappers run first the JOSM validator before submitting one task and they check errors if there are any. Then, they go back to the ID editor and activate the OSMOSE verification to check and correct any further errors before submitting it as a “mapped” task.
  • After a task is marked as mapped, a second validation step is done by the most experienced members of our team (see list below), who check whether all geographic data is correctly mapped and fix any errors or missing data.

Along the mapping process, experienced supervisor oversees the progress and quality of the mapping done by the four mappers. Separate from the validation step, supervisor visually inspect daily a high proportion of the tasks mapped and run similar diagnostics as described above to check that there are no errors left. Supervisor has frequent discussions with the mappers to ensure consistency in data creation across the team, identify any consistent or sporadic issues that may arise and solve them as a group. The goal is to produce high quality data that is usable for operational purposes on the field. We pay particular attention to the points below:

  • The building shadow should not be included in the building outline
  • Buildings may be very close but should not touch each other
  • A road should always be connected to another road.
  • A waterway should always be connected with another waterway, not to a land use.
  • When a road crosses through a stream or river with a bridge, we use the tag “bridge”, If no bridge is visible, we use the tag “ford”

Time frame

Mapping work began in February 5, 2024 due to end in September 30, 2024 for a duration of 8 months.

Mappers and validators

List of mappers and validators are below:

Mappers Validators
1 Elysé Andriatahiana (Elysé2 ) 1 Felana Ihantamalala (Allyas )
2 Koly Rabetsimialona (nicyK19) 2
3 Lalaina Andriantavy (Janny Lalaina ) 3
4 Ony Razafitseheno (Andiantsoa ) 4

Contact

If you have any questions about this project, you can contact us via an email to the project’s principal investigator, Dr. Felana Angella Ihantamalala (fihantamalala@pivotworks.org)

Hashtag

We use the tags #geohealthresearch-project-XX #PivotscienceActivity #geographicalbarriers #vatovavy