Abstract
Africa is generally held to be in crisis, and the quality of life for the majority of the continent's inhabitants has been declining in both relative and absolute terms. In addition, the majority of the world's disease burden is realised in Africa. Geographical information systems (GIS) technology, therefore, is a tool of great inherent potential for health research and management in Africa. The spatial modelling capacity offered by GIS is directly applicable to understanding the spatial variation of disease, and its relationship to environmental factors and the health care system. Whilst there have been numerous critiques of the application of GIS technology to developed world health problems it has been less clear whether the technology is both applicable and sustainable in an African setting. If the potential for GIS to contribute to health research and planning in Africa is to be properly evaluated then the technology must be applicable to the most pressing health problems in the continent. We briefly outline the work undertaken in HIV, malaria and tuberculosis (diseases of significant public health impact and contrasting modes of transmission), outline GIS trends relevant to Africa and describe some of the obstacles to the sustainable implementation of GIS. We discuss types of viable GIS applications and conclude with a discussion of the types of African health problems of particular relevance to the application of GIS.
Highlights
The physical and ecological structure of Africa is as varied as its social, political and demographic characteristics [1]
The applications of geographical information systems (GIS) to health and epidemiology have been critiqued by numerous authors [4,5,6,7,8,9,10,11,12,13] and found to be under-utilised it has been concluded that GIS has much to contribute to the health sciences
GIS is a tool of great inherent potential for health in Africa as health is largely determined by environmental factors which vary greatly in space
Summary
The physical and ecological structure of Africa is as varied as its social, political and demographic characteristics [1]. The most cost-effective answer to the data deficit and poor vital registration and health statistics problem in Africa is the establishment of sentinel geo-referenced demographic and health surveillance systems[85] This will enable the elucidation of small-scale disease patterns (e.g. diffusion dynamics) that could be modelled using coarser resolution data and the coverage extended. The first category involves the use of GIS as a research tool These applications should seek to provide new insights into the spatial dimensions of disease and new methodologies to more cost-effectively allocate resources to health services. These types of applications will normally use high-end systems with significant analytical functionality and will usually involve a significant amount of additional data collection. The MARA collaboration is a successful example of this type of approach and is embedding several of its research outputs in the freely available GIS software HealthMapper (developed by WHO) for intervention planning in Africa at a district level
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