Primary health can fall by the wayside in fragile settings. Mapping performance is a useful starting point to increase standards.
Conflict and natural disasters often affect the delivery of health services. Mapping facilities and understanding where there are gaps or damage is essential to identifying what improvements are needed, both in terms of access and performance. A starting point is to measure factors such as staff and medicine availability, hygiene and basic infrastructure.
The need to map primary health facilities
Mapping primary health facilities is essential for understanding how to improve healthcare in fragile settings. In many situations, particularly those which are fast moving, there is minimal reliable information about the number, location and condition of health facilities in affected areas.
Using rapid independent monitoring as a solution
Rapid independent monitoring can be an effective way of quickly mapping primary health performance in developing countries. In one country where we worked, when there was a need to map primary healthcare facilities across various regions, we hired 50 independent monitors from within local communities to rapidly assess the system.
Five experienced regional coordinators delivered hands-on, in-person training for the monitors within days. The monitors were then ready to visit health facilities.
Using focused surveys, they visited facilities, collecting data that enabled the display of real-time views of performance. The dashboards showed factors including staff hiring, completion of training, general hygiene levels, opening hours and medicine delivery rates.
The results
Within just ten days, the 50 freshly trained monitors visited over 350 health facilities across the country. Along with the scale of health facilities visited, initial deliverables were available for review and use just a few weeks after data collection.
As a result, interactive dashboards, maps and tools were in place to visualise the system. Moreover, maps, tables and insights showing population distribution to the nearest health facility and estimated health facility catchment size were created to model access. Also available was a comprehensive health facility database, with granular data for individual facilities.
"Within just ten days, the 50 freshly trained independent monitors visited over 350 health facilities across the country."
Mapping primary health performance in fragile settings ultimately helps to identify how improvements can be made. It shows the regions and key functions that need support, such as medicine availability, hygiene and staff numbers. Using technology as a way of obtaining this information can accelerate data gathering and improve data quality.
