Presented by Yohana Mapala, MEASURE Evaluation/Futures Group, at the July 2012 Workshop on Mapping Community Based Global Health Programs for M&E.

1. Experience with Community-
Based Mapping:
Iringa, Tanzania
Yohana Mapala
MEASURE Evaluation/Tanzania
20 July 2012

3. The Setting
Iringa Region
16% adult HIV prevalence

4. The Issue
 Where are the transmission
hot spots?
 Where are the prevention
services?
 Are the right services in
the right places?

5. The Approach
 Locate the transmission
hot spots
 Map the prevention
services
 Overlay transmission hot
spots with service locations

6. The Approach
 Locate the transmission
hot spots

7. Locate the transmission hot spots:
The Solution
 Priorities for Local AIDS
Control Efforts (PLACE)
Rapid Assessment

8. What is PLACE?
 Developed by MEASURE Evaluation
 Asks where high-risk behaviors occur
 Implemented in 20+ countries to date
8

9. Locate the transmission hot spots:
The Solution
 Select sample villages and
“mtaa”; add “special places”
 Interview informants
 Compile “hot spots”
 Visit venues

10. The Sample
 All 7 districts
 69 villages and “mtaa”
o probability of selection proportional to population
size (Tanzania National Bureau of Statistics)
 “Special Places” with presumed high risk
o truck stops, plantations, mines, other
10

11. Community Informants
 9 to 12 adult informants per area
 Village or street leaders
 Knowledgeable about area
 Listed venues/events where people go to meet
new sexual partners.
 Provided other insights into risk behaviors
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12. Informant interview

13. Venue Visits and Mapping
 Compile list of venues and events
 Visit the venues named by the most informants
 Observe conditions at venue
 Interview someone onsite
 Record GPS coordinates
13

14. Venue visit

15. Results: Community Informants
 136 sampled areas
 1,333 community informants interviewed
o bar workers, street vendors, mechanics, farmers,
health workers, community leaders, and others
 Identified 2,314 unique venues
 Identified 1,533 events
o religious activities, funerals, auctions/market days,
weddings
15

16. Results: Venue Visits
 Visited 484 most-commonly mentioned
venues
o 234 informal bars (48%)
o 111 formal bars (23%)
16

17. Venue Locations
17

18. Venues by Number of Patrons
650 - 1500
350 - 650
145 - 350
62 - 145
5 - 62
18

19. The Approach
 Locate the transmission
hot spots
 Map the prevention
services

20. Map the prevention sites:
The Challenges
 Include all USG-supported
prevention sites

21. USG-Supported Services
 Condom distribution (wholesale, retail)
 VCT
 Mass media promotion
 Male circumcision
 HIV treatment
***********************************************************************************************************************
 Home based care
 PMTCT
 OVC

22. Map the prevention sites:
The Challenges
 Include all USG-supported
prevention sites
 Estimate their coverage
areas
 Many in remote rural areas
 Limited budget and short
time frame
 Rainy season!

23. Map the prevention sites:
The Solution
Visit District Health Officer
Visit Site
• Take GPS reading Identify key
• Photograph site informant
• Explain paper maps
• Pin-point where “most” clients
come from
Hybrid approach: direct (GPS) and paper-based mapping

25. Map the prevention sites:
The Solution
Visit District Health Officer
Visit Site
• Take GPS reading Identify key
• Photograph site informant
• Explain data collection
• Pin-point where “most” clients
come from
Photograph the map

26. Map the prevention sites:
The Solution
Visit District Health Officer
Visit Site
• Take GPS reading Identify key
• Photograph site informant
• Explain data collection
• Pin-point where “most” clients
come from
Photograph the map
Integrate map into GIS

27. The Approach
 Locate the transmission
hot spots
 Map the prevention
services
 Overlay service locations
with transmission hot spots

28. Putting it all together:
Hot spots and VCT coverage
Hot spot, no condoms
Hot spot, condoms unknown
Hot spot, condoms seen
Hot spot, condoms claimed
VCT facility coverage

29. From the region to the district…

30. Putting it all together:
Hot spots and condom distribution
Hot spot, no condoms
Hot spot, condoms unknown
Hot spot, condoms seen
Hot spot, condoms claimed
Condom retail site

31. Putting it all together:
Hot spots, condom distribution and VCT
Hot spot, no condoms
Hot spot, condoms unknown
Hot spot, condoms seen
Hot spot, condoms claimed
VCT facility coverage
Condom retail site

32. Putting it all together:
Hot spots, VCT, and Radio
Radio tower reach
Hot spot, no condoms
Hot spot, condoms unknown
Hot spot, condoms seen
Hot spot, condoms claimed
VCT facility coverage
Condom retail site

33. Putting it all together:
Population reach of VCT
Population Density
(people/square km)
0-1
1-20
20-50
50+
VCT facility coverage

34. Now what?
 “Highlights” shown to 2 District Executive
Directors (out of 7 in Region)
 Shared results with USAID Iringa Prevention
Working Group
 Planned GIS/DDU workshop in August

35. MEASURE Evaluation is a MEASURE project funded by the
U.S. Agency for International Development and implemented by
the Carolina Population Center at the University of North Carolina
at Chapel Hill in partnership with Futures Group International,
ICF Macro, John Snow, Inc., Management Sciences for Health,
and Tulane University. Views expressed in this presentation do not
necessarily reflect the views of USAID or the U.S. Government.
MEASURE Evaluation is the USAID Global Health Bureau's
primary vehicle for supporting improvements in monitoring and
evaluation in population, health and nutrition worldwide.