Mapping PMTCT: Geovisualization of the Abbott Fund Global PMTCT Test Donation Program Andrew Schroeder, PhD, MPP Director of Research and Analysis Direct Relief International
Direct Relief International OUR MISSION: Bolster health systems for the medically underserved by equipping skilled providers in resource poor settings with targeted and consistent flows of medically appropriate pharmaceuticals, supplies and biomedical equipment. Founded in 1948 Based in Santa Barbara, CA Distribution network in 60 countries, including the United States
The Geographic Turn at Direct Relief: WHERE Matters Analysisl i Spatial Disaggregation Spatial Disparities Spatial Non-Stationarity Visualization Rapid Pattern Recognition Accelerated Hypothesis Formation Communication Data-Driven, Image-Rich Messaging g From the General to the Spatially Particular
Transnational Socio-Technical i Collaboration Direct Relief Abbott Fund Rwanda MOH 4
Partnership with Managing logistical partner since January 2008 for the Abbott Fund s global PMTCT Rapid HIV Test Donation program
The PMTCT Rapid HIV Test Donation Program Over 11.5 million tests donated to partners in 39 countries since 2002 3.5 million test kits distributed to 24 countries in 2008 61 donation recipients provided HIV testing at over 7,000 sites worldwide in 2008
The Abbott PMTCT Rapid HIV Test Donation Program in Rwanda 880,000 test kits distributed to the Rwandan MoH in 2008
Socio-Technical i Collaboration with Rwanda s MOH The TracPlus System 8
Mobile Phone Coverage Rwanda 2008 9
Remote Data Collection. SAMPLE DATA PCs/ Internet Cell Phone PDA/ Smartphone Phone Local Applications 10
Outlines of the PMTCT Mapping Project Augment aggregated donation recipient reporting with site-level specificity Use site level specificity for enhanced program Analysis, Visualization and Communications Map East Africa first -- extend eventually to all Abbott PMTCT Test Donation recipient countries
Key Software: ArcGIS Desktop and Server 9.3 Commercial GIS software from ESRI GeoDa Free geographic analysis software from Arizona State s GeoDa Center for Geospatial Analysis and Computation Google Earth Free geographic browsing and geovisualization software from Google.
Test Case #1: HIV and PMTCT in Rwanda
Facility-Level Reporting: Where is testing ti taking place? Legend PMTCT HIV+ Rates PCT_Pos < -1.5 Std. Dev. -1.5 - -0.50 Std. Dev. -0.50-0.50 Std. Dev. 0.50-1.5 Std. Dev. 1.5-2.5 Std. Dev. > 2.5 Std. Dev.
District Level HIV Prevalence: Where do disparities in testing rates exist? Legend PMTCT HIV+ Rates PCT_Pos 0.000000-0.017391 0.017392-0.027512 0027513-0.027513 0040670 0.040670 0.040671-0.072064 0.072065-0.143807
Local Spatial Smoothing & Outlier Analysis: Where do we find areas of high h and low testing outcomes? Legend PMTCT HIV+ Rates PCT_Pos 0.000000-0.017391 0.017392017392-0.027512027512 0.027513-0.040670 0.040671-0.072064 0.072065-0.143807
Clustering and Hotspot t Analysis: Do testing results exhibit spatial structure? Legend Local Moran's I Clusters CL_PCT_POS Not Significant High-High Low-Low Low-High High-Low
Next Steps Expand site-level mapping to all Abbott PMTCT Rapid Test recipient countries Link testing data to treatment data Link Abbott PMTCT Test Donation program data to DHS (Demographic and Health Surveys), WHS (World Health Surveys) and MICS (Multiple- Indicator Cluster Surveys) y) Serve geographic health data and maps to the global public sphere through the Abbott PMTCT Test Donation program website
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Our Vision: i Geographic Health Information as a Platform for Social Cooperation Geographic Specificity i of Health Information Free Distribution of Maps, Data and Analysis Open Source Global Public Health Intelligent Transnational Collaboration