Health Services Planning, background document

Workshop on the Impacts of Poverty Maps:
Past Experiences and New Applications, Brussels Workshop, May 21st, 2003

Application Impacts How the impacts can be enhanced
The UN World Food Programme and Macro International are developing nutrition indicators in Cambodia. Indicators such as stunting and underweight rates are being mapped at the commune level. The nutrition indicators will improve targeting of health services in Cambodia next fiscal year (2003-2004). The indicators have preliminarily influenced the targeting of a “Mother and Child Health” program in some Cambodian provinces. Other data such as economic potential could be incorporated for more sophisticated analyses.
Maps of poverty, sanitation, water supply, and cholera incidence were used to help contain a cholera outbreak in South Africa’s KwaZulu Natal province in early 2001. An environmental health strategy – that heavily relied on these maps – effectively contained cholera within three months. This achieved one of the world’s lowest ever recorded fatality rates at 0.22% (among approximately 100,000 cases). Compatible data sets are vital in analyses and for data comparisons. The combination of data indicates the potential of using poverty maps for environmental and other applications.A collaborative interagency approach, involving Statistics South Africa, Department of Health, and Department of Water Affairs, was extremely beneficial.
Friends of the Earth UK compared poverty and pollution maps in England and Wales to evaluate if poorer communities are indeed at higher risk to cancer causing emissions. Average income by postcode was used to map poverty, and compared to emissions levels. This raised awareness that poorer communities are more likely to be exposed to health risks. The study showed that 66% of carcinogenic emissions are concentrated in the poorest areas. This information is being used to lobby the government the need to for policy measures to reduce industrial pollution.
A DFID programme will develop, test, and refine tools to link poverty and health data in Africa, Asia, Latin America, and Eastern Europe (14). This will assist in planning health services for the poor by improving the collection of health and related data, monitoring and performance of health systems, and evaluation of health sector reform. Synergy with programs working on poverty mapping is vital. The DFID programme will draw on best practices on using indicators for measuring, monitoring, and evaluating health system performance.
The Global Programme for Health Policy is developing sub-national global poverty maps for global disease risk mapping (15). It will use city lights/income data to create regional and global poverty maps. This will raise awareness on the need to include poverty maps in evaluating global disease risk.