In combining machine-learning-based algorithms with a motorcycle mapping approach, HOT generated comprehensive base map data of North Kivu and Ituri provinces in the Democratic Republic of Congo and the bordering districts in western Uganda to better guide and inform local actors, such as health care workers, government representatives and national/international organizations, of where humanitarian assistance should be delivered.

Patient tracking is a crucial public health activity that contributes to reducing the spread of highly contagious diseases. However, patient tracing, tracking, and monitoring in low-and middle-income countries is a complex process as most of the geographical, navigational, and landmark features are not fully digitized. In 2019, with funding from the Humanitarian Grand Challenge, the Humanitarian OpenStreetMap Team (HOT) embarked on a project to scale the Missing Maps initiative across the public health and disease surveillance sector in Uganda and the Democratic Republic of Congo (DRC). The project was carried out between September 2019 to January 2022.

In Uganda, HOT partnered with district and community health teams to design a community participatory mapping exercise across Kisoro and Zombo districts. This mapping exercise included locating and mapping all geographical and human-made features within the districts that would enable community health workers to easily find, locate, and trace patients quicker and more efficiently.

Methodology

Remote mapping

Remote mapping and validation exercises were carried out in the priority districts of Kisoro, Zombo, Kanungu, Rubirizi, Rukungiri, Isingiro, Kamwenge, Kyegegwa, Ntoroko, Bundibugyo, Kikuube, Kasese, Hoima, Kiryandongo, Maracha, Nebbi, and Koboko. Over 2.5 million building footprints were added to OpenStreetMap (OSM).

Field data collection

HOT carried out two separate data collection activities which began in December 2020 in Kisoro district and continued to Zombo District from March 2021. The fieldwork included the collection of geographic information of different amenities located in these two districts.

Data collectors were split into subgroups and sent to different parishes of a particular sub-county to ensure surveyors were adequately assigned to tasks and could be followed up with in case of any issues as well as ensure proper data management as related to data quality or inconsistencies.

A total of 30 surveyors were trained on OpenDataKit and OpenMapKit to carry out the data collection on village locations, education facilities, health facilities, water points, places of worship, market places, and offices, including government and non-government offices.

At the end of the field mapping period, the data was reviewed, validated, and uploaded to the OSM platform.

Maps

The HOT team collaborated with the district health team to design and produce village-level, book-sized maps. These book-sized maps were distributed to the village community health workers to help them navigate, locate, and record their movements even without using smartphones. The aim is to develop district-level gazetteers that will be shared with health centers across the district to assist in reducing the time spent on patient tracing.

Use cases

In Kisoro, the maps have helped district authorities bring services closer to the people. According to the Assistant District Health Officer (DHO), the maps have helped in solving problems of outreach coverage, especially during the child immunization exercise under the Ministry of Health plan - REC - Reaching Every Child.

Dr. Nick Muneza, the Assistant District Health Officer (DHO) in Kisoro illustrates how the maps have contributed to streamlining immunization efforts in the district.

• “One week after we got the maps, we were able to change one child immunization outreach post in Nyakinama sub-county. The post was meant to serve people in Nyakinama and had been placed in Mubuga. We realized that instead, it was serving people from Nyarubuge. So according to the map, we were able to locate that the most suitable place for this outreach post is Kwaranga. Now we have more people from Nyakinama utilizing the post for immunization.”

Dr. Nick Muneza, Assistant District Health Officer, Kisoro, Uganda

Kajyibgami Kenneth, 67, the chairman of the village health teams (VHTs) in Chahi Sub County reports that during the height of the COVID-19 outbreak in Uganda, it was very easy for them to quarantine people and predict the extent of spread according to the locations on the maps.

• “Every village has a map. Two VHTs share one map per village. It is now very easy to trace and direct patients to the nearest health center. Our only challenge is that we don’t have smartphones. Our work would be faster if we had these phones.

He adds that the process has now been made more accessible with the introduction of hard copy maps for some of the VHTs in his sub-county who had no access to smartphones.

Assistant District Health Officer, Dr. Nick Muneza at the District Health Office Kisoro District with a copy of the new map created by HOT with support from the Village Health Team.

Additional maps are available from the Scaling Missing Maps Atlas

Our gratitude goes to the Humanitarian Grand Challenge and partners for funding the Missing Maps initiative across the public health and disease surveillance sector in the Great Lakes Region.

Special thanks and recognition to the local government, community members, and surveyors who collaborated with the HOT team throughout this project; the success and impact of our activities could not have been possible without their full support and participation in the mission.