Towards a Participatory Methodology for Community Data Generation to Analyse Urban Health Inequalities: A Multi-Country Case Study

This paper has been publised in the Proceedings of the 52nd Annual Hawaii International Conference on System Sciences

Abstract

This paper presents results from the application of a methodological framework developed as part of an ongoing research project focused on understanding inequalities in the healthcare access of slum residents of cities in four countries: Bangladesh, Kenya, Pakistan and Nigeria. We employ a systematic approach to produce, curate and analyse volunteered geographic information (VGI) on urban communities, based on a combination of collaborative satellite-imagery digitization and participatory mapping, which relies upon geospatial open-source technologies and the collaborative mapping platform OpenStreetMap. Our approach builds upon and extends humanitarian mapping practices, in order to address the twofold challenge of achieving equitable community engagement whilst generating spatial data that adheres quality standards to produce rigorous and trusted evidence for policy and decision making. Findings show that our method generated promising results both in terms of community engagement and the production of high-quality data on communities to analyse urban inequalities.

Keywords: Innovations in Health Equity
Information Technology in Healthcare
collaborative mapping, OpenStreetMap, participatory mapping, urban inequality, slum

Slum health mapping as catalyst for a collaborative agenda for research, practice, local citizens and volunteers

Presentation by João Porto de Albuquerque, Godwin Yeboah, Vangelis Pitidis, and Philipp Ulbrich at State Of The Map 2018

Abstract

Background and purpose. Following the paradigmatic examples of the use of OSM for crisis mapping, there have been sustained efforts to use OSM for mapping preventively vulnerable communities in the global South. This includes, for instance, participatory mapping in the slums of sub-Saharan Africa (Hagen, 2017) and the Missing Maps project. Researchers have also started to study these mapping activities (e.g. Albuquerque et al. 2016; Herfort et al. 2017). However, a collaborative agenda in this area is missing that is able to reflect views and needs of researchers, OSM volunteers, humanitarian organisation practitioners and local communities.

Methodology and Findings. After a brief review of existing methods used for mapping disadvantaged communities and slums, we introduce the approach and report on preliminary results from an ongoing large-scale project (NIHR Global Health Research Unit on Improving Health in Slums), which uses OSM for mapping slums in five cities: Dhaka (Bangladesh), Karachi (Pakistan), Nairobi (Kenya), Ibadan and Lagos (Nigeria). Our methods are based on the combination of satellite imagery digitisation with ground-truthing and participatory mapping. The maps produced will result in enhanced information regarding environmental features of the slums and the location of healthcare facilities, which will also be used as a basis for the health-science surveys of the project. In this manner, our approach is aimed at achieving a threefold goal: (a) participation and inclusion of local stakeholders as a strategy to build resilience; (b) worldwide collaboration, connecting to the global Humanitarian OSM network and student mapping societies; (c) quality evaluation mechanisms for generating high-quality data that can also be used for scientific research.

Final discussion/Impact. We would like to discuss the approach and results of our project as a basis to invite OSM researchers, practitioners and volunteers to join us in defining a collaborative agenda towards improving methods and practice for mapping vulnerable communities in OSM. This should include challenges from an interdisciplinary perspective that account for technical, methodological, social and ethical issues. As a result, we would like to contribute to the emergence of an OSM research agenda that goes beyond solely using OSM geographic data for research, but also includes ways of engaging the OSM community and local communities in the research process.

Recorded audio presentation from SoTM2018 event (YouTube)

Tweets from SoTM2018 event

Question time snapshots after our presentation (click photo to see source url)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 The research waphrc.orgas commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

 

Mapping for better healthcare in Nairobi’s slums

By Mwangi Chege, Carol Wainaina and Caroline Kabaria

Slum areas are not just defined by the presence of poverty, they are also characterized by the near absence of public services. Residents of these areas often cannot access quality health and education services while infrastructure for water, sanitation and energy is usually woefully inadequate. This has impacts on the health and well-being of people who live in slums.

APHRC research has shown that slum dwellers have similar if not worse health outcomes than rural poor populations. High rates of infant mortality and deaths from infectious diseases as well as diarrheal diseases reflect the hard reality of life in slums. This is striking because many slum residents are people who left rural areas for urban centers, seeking to improve their quality of life.

In cases where public services such as clinics and hospitals within slums are provided, barriers to access still remain. Lack of financial resources can make it difficult for slum residents to utilize the few available facilities. Sometimes they simply cannot afford to take time off from work to seek the care they need. Poor political will on the part of municipal authorities may also result in the needs of slum residents being neglected.

APHRC has partnered with the University of Warwick to study healthcare-seeking practices among people living in the Nairobi slums of Korogocho and Viwandani. The study will also explore factors that influence these practices such as cost of healthcare, accessibility of facilities and quality of care. Other study cities include Ibadan, Nigeria; Karachi, Pakistan, and Dhaka, Bangladesh. Evidence from these diverse sites will improve understanding of what it takes to achieve effective and efficient delivery of healthcare for the urban poor.

A mapping marathon

One of the study activities is a mapping exercise to identify where healthcare facilities are located in Korogocho and Viwandani, to support further analysis on accessibility and costs. The first phase of this mapping was conducted in a mapathon held at the APHRC campus in January 2018. The mapathon involved university students, professional mappers, representatives from Korogocho and Viwandani as well as staff from the center. Their mapping skills ranged from novice to master-cartographer. These ‘citizen mappers’ used satellite images, existing maps and geographic information systems (GIS) software to add missing features and modify existing ones so that the maps are a more accurate representation of reality. Specific features that they were identifying included roads, health facilities, water sources and sanitation points in the two slum areas.

Professional mapper, Zachariah Muindi who has participated in a number of mapathons remarked on the importance of mapping slum areas. “Maps and geographic data can be used to tell stories from communities as well as address development challenges. Different organizations can use the data to provide solutions to needs that are highlighted by the maps. For instance, humanitarian organizations use this data when they are planning for provision of aid to areas affected by natural disasters.”

Participation by community members at the event was critical, because of their intimate familiarity with the areas being mapped. It also provided an opportunity for empowerment, as the skills they learned during the mapathon can be adapted and used for other community-building activities.

“The mapathon was totally a new experience for me! I only ever really use maps to get directions,” one of the participating APHRC staff members said. “By the end of it all I was impressed at what I had accomplished despite having no knowledge or experience in mapping.”

Speaking on his overall experience at the mapathon, Muindi said, “My experience at the mapathon was fantastic. I was able to map several buildings in Viwandani and to also assist in modifying buildings that had been mapped in an earlier exercise. Data accumulated through the mapping exercise will go a long way in assisting APHRC to provide lasting solutions for the people of Korogocho and Viwandani.”

The mapathon was just the first step in understanding patterns of health service delivery within the two Nairobi slums; the resultant maps will feed into the long-term project goal to develop viable models for delivery of health services in slums worldwide. While slums will continue to be part of our urban reality, poor healthcare service provision in these areas should not.

A citizen mapper at work during the mapathon hosted at APHRC campus
A citizen mapper at work during the mapathon hosted at APHRC campus
APHRC staff also participated in the mapathon to map health facilities in Korogocho and Viwandani
APHRC staff also participated in the mapathon to map health facilities in Korogocho and Viwandani

 

 

 

 

 

 

 


 The research waphrc.orgas commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.