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Laboratory Landscapes: GIS for Laboratory System Strengthening in the BD-PEPFAR Labs for Life Program

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Page 1: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Laboratory Landscapes:GIS for Laboratory System Strengthening in the BD-PEPFAR Labs for Life Program

Page 2: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri
Page 3: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

What’s the problem that lab GIS tries to solve?

Page 4: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

High disease burdens

Page 5: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

High poverty and inequality

Page 6: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Growing populations

Page 7: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Large but inefficient and under-funded systems

Page 8: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Uneven distribution of diseases, people and systems.

Page 9: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Lots of laboratories*

* Depending on the definition of “laboratory”

Page 10: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Lots of diagnostic technology*

*Much of which is past its useful life and frequently broken

Page 11: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

But fragmented information

Page 12: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Limited strategic views

Page 13: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Difficulty responding quickly and accurately

Page 14: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

In other words, we need an integrated picture

Page 15: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

What’s happening in lab systems overall?

Page 16: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Plan, measure and adjust

Page 17: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

In near-real time

Page 18: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

And in multiple dimensions

Page 19: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Test results Health records

Repair and Maintenance

Training and Human Resources

Quality Indicators

Material Inventory

Page 20: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

UUganda LLab GIS

Thanks to Moses Jolobaand Uganda’s National TB Reference Lab, who produced all the work below for Uganda.

Page 21: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

KKey Areas of Lab GIS Innovation in Uganda

• Geocoding public health laboratories to understand national network

• Tracking spatial distribution of quality improvement activities

• Tracking specimen referral system for network enhancements

• Tracking MDR-TB cases for rapid intervention

Page 22: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri
Page 23: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

TTracking Specimen Referral

Legendlakes

Health CentersNumber of samples sent

0

1 - 3

4 - 8

9 - 20

21 - 250

Districts 2010

Population densities 20100 - 50

51 - 100

101 - 250

251 - 500

501 - 800

801 - 8224

Page 24: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

TTracking MDR-TB

Page 25: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

EEthiopia LLab GIS

Thanks to Gonfa Ayana and the Ethiopian Health and Nutrition Research Institute (EHNRI)

Page 26: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Partnership:Public – Private – Non-Profit - Academic

Page 27: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Direct Relief – EHNRI – BD Lab GIS TeamFebruary, 2012

Page 28: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

Where are the labs?

Where is the equipment?

How are results distributed?

How are results transported?

What is most in need of repair?

Where are supplies most needed?

Which facilities are in greatest need?

Page 29: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

GIS

Lab Info Systems

Specimen Referral

Baseline Surveys

Equipment Database

Quality Assessment

Data

HMIS

System-wide Data Integration

Page 30: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

KKey Challenges

• Ubiquitous paper forms

• Regional semi-autonomy

• Sporadic communications network coverage

• Vendor competition among information systems

• Low-level data science / GIS training

Page 31: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

PProvisional Responses

• Use existing LIS-installations and track referrals through regional systems

• Use flexible query system rather than direct system integration

• Use combination of outreach and SMS reporting

• Lowest common denominator data integration

• Build training resources at national and regional levels

Page 32: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri

PPreliminary Ethiopia Maps: Lab Equipment / Malaria Survey / Measles Cases

How are essential healthcare resources distributed?

Page 33: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri
Page 34: Uganda Lab GIS - Esri › library › userconf › proc... · 2013 Esri International User Conference (Esri UC), Presentation Keywords: 2013 Esri International User Conference (Esri