Using GPS Data to DELIVER Health Products to People Faster

In Healthcare, mHealth, USAID on April 15, 2014 at 3:46 pm

Andrew Inglis, GIS Team Lead at John Snow, Inc. for the USAID | DELIVER PROJECT, describes how his team used GPS technology to map road networks in Ebonyi State, Nigeria. The USAID | DELIVER PROJECT is funded by USAID.
Imagine driving a delivery truck without a map or any idea how long it will take to get to your destination. The drivers delivering health commodities in Ebonyi State, Nigeria were dealing with this very problem. Existing digital data for the road network contained information on travel speeds for five percent of the roads, and only half of the roads were mapped at all.

This lack of detail on the Ebonyi road network was a major roadblock for the USAID | DELIVER PROJECT. Without this information, it was difficult for logistics teams to estimate how long it would take to travel to facilities and thus how best to schedule deliveries. Additionally, because of the varying quality of roads and conditions between seasons, estimates of travel times and distances were unreliable. Recognizing the importance of addressing this issue, technical and program management teams on the USAID | DELIVER PROJECT put their heads together.

In this collaboration, the teams realized they already had access to the information they needed: in the GPS devices installed in all delivery trucks as a security mechanism. Having GPS coordinates means knowing the exact geographical latitude and longitude of a location, another critical component to streamlining logistics. During delivery runs, trucks with GPS security devices take GPS recordings during set regular intervals when in motion as well as every time the truck’s engine is turned off or started. Starting with the information automatically collected on the GPS devices during delivery runs, the team overlaid these data onto the existing road network data. They then created a new map that essentially “connected the dots” between the existing data and the new data. All that was needed were three GPS coordinates taken from the delivery truck per section of road to calculate an average travel speed. For roads where GPS data could not be collected, the project took information about the road quality (paved, gravel, or dirt), and the location of the road to estimate a travel speed based on similar roads in the nearby area. This method allowed for the doubling of the digital road network in the state.

Figure 1. Original Road Network Map

Now, USAID | DELIVER PROJECT is using this road network and calculated travel speeds to plan delivery routes in Ebonyi State. Using the new digitized road network makes it possible to determine the most optimal route for each truck, reducing travel time and distance traveled. The best part about having this information is that the project staff can predict the day and time that the truck will arrive at each of the 200 health facilities in the state, reducing the chance for stockouts and making it easier for health facility staff to maintain their inventory.

The GPS data provided an additional benefit to the project: it helped confirm the GPS coordinates for 42 health facilities. By using time stamps taken by the GPS devices, Ebonyi State now has exact coordinates for 187 out of the 204 health facilities, and will soon have them for the remaining 17.

Figure 2. Road Network Map with Incorporation of GPS Data

Figure 2. Road Network Map with Incorporation of GPS Data

Using GPS data in this way is a strategy that could easily be adopted by other projects. The USAID |DELIVER PROJECT is currently working to make the digital road network maps available to the public. Making the road network maps and data available to other organizations or government entities working in Ebonyi State would provide the opportunity for them to use the information on travel speeds and road conditions to help streamline their programmatic logistics and delivery systems.

The USAID | DELIVER PROJECT innovates to streamline the process of getting products to patients as dependably and cost effectively as possible. Check back with the USAID | DELIVER PROJECT to learn more as we scale up our GPS mapping in other states of Nigeria, as well as in other partner countries to support USAID objectives and interventions.

Figure 3. DELIVER Staff in Nigeria unload their first delivery run in Ebonyi, January 2013. Photo Credit: Emmanuel Ogwuche

Tanzania’s Child Gold Miners Face a Multitude of Health Hazards

In Children, Healthcare on April 5, 2014 at 9:33 pm

Mining is among the most perilous forms of child labor. Global Health Africa contributor, Neha Ahmed, calls attention to the multitude of health hazards child gold miners face in Tanzania.
In August of 2013, a report by Human Rights Watch warned that thousands of children, some as young as eight years old, were working in Tanzania’s small scale gold mines. Tanzania is the fourth largest producer of gold in Africa and gold has recently overtaken tourism as the country’s biggest foreign exchange earner. Despite the present laws prohibiting child labor, the practice remains widespread and children working in small scale gold mines continue to lead precarious lives with ongoing exposure to a multitude of health hazards.

Mining is among the most perilous forms of child labor. The health threats faced by children working in gold mines are numerous including musculoskeletal injuries from carrying heavy loads, injuries due to a lack of safety equipment, working in mine shafts which can collapse suddenly, and exposure to toxic chemicals such as mercury. Among child gold miners, exposure to mercury can occur in a number of different ways and carries with it a range of health risks, both short and long-term. Initially, elemental mercury is used to extract gold from the ore in which it is embedded. The next step in the gold extraction process requires the burning of the mercury-gold amalgam in order to purify the gold, which is then washed off with water. These processes result in mercury contamination both as run-off that pollutes water sources and as toxic vapor that can be inhaled by miners and the local community, causing either immediate or chronic toxic exposures for the child miners as well as their families and communities.

Mercury poisoning is known to cause a number of immediate detrimental health effects including blistering, swelling and fatigue. Research on the effects of mercury exposure has also provided evidence of long-term health damage including lowered fertility, heart disease, respiratory disease, musculoskeletal problems and poisoning. Moreover, mercury poisoning is particularly harmful to developing fetuses and young children since it can permanently impair cognitive functions and result in developmental deficits such as IQ loss and delayed speech.

In 2009, the Tanzanian government launched both the National Action Plan for the Elimination of Child Labor as well as The National Strategic Plan for Mercury Management. Tanzania also played a positive role in pushing for the Minamata Convention on Mercury, an international treaty regulating the use of the substance. However, as the Human Rights Watch report acknowledges, enforcement of these action plans and treaties remain an issue. Inspections of mining sites are sporadic and inconsistent, with the relevant government ministries lacking the resources required to enforce laws.

In addition, there is a failure to critically assess and attend to the underlying socioeconomic vulnerabilities that pave the way for precarious artisanal mining and the involvement of child labor in the activity. Working with mining communities immediately to improve working conditions and encourage safer workplace practices is important, as is enforcing adherence to child labor laws. However, for sustained and broad based changes to occur, it remains critical to take action on extensive issues such as landlessness among rural communities, improving access to education particularly secondary education, providing greater opportunities for vocational training, and providing support programs and transition opportunities to vulnerable children. This video shows the dangers that child gold miners encounter in Tanzania’s gold mines.

Tackling the Health and Economic Risks of Child Marriage

In Healthcare, Youth on March 29, 2014 at 3:52 pm

What will it take to end child marriage? GHA blogger, Sophie Okolo, points out the recent change in dialogue and highlights the health and economic risks of child marriage in Africa.

Early this year, the conversation about child marriage shifted from human rights to that of health and education. Child marriage is still a hot button issue in many African countries hence this change was significant. By shifting the conversation, public health professionals can address this issue in a tactful way since cultural beliefs are difficult to change. Like any important issue of our time, finding creative ways to address such issues can lead to a change of heart and eventually, cultural transformation.


Despite recent condemnation of child marriage in many African countries, tradition and beliefs continue to ruin young lives in remote regions. For example, child marriage is prohibited under Nigeria’s Child Rights Act (enacted in 23 of 36 Nigeria’s 36 states), which bans marriage or betrothal before the age of 18. But federal laws compete with age-old customs, as well as a decade of state-level sharia law in Muslim states. Last year, the Nigerian Senate came under attack for failing to include the age at which girls can get married thereby condoning child marriages. These customs and laws should be challenged although health information can go a long way in addressing this critical issue. For instance, girls who marry too young are denied the educational opportunities of their peers and are put at greater health risks, such as HIV and teen pregnancy. Teen pregnancy may lead to a difficult and prolonged labor which can result in a fistula, an abnormal connection between an organ, vessel, or intestine and another structure that causes uncontrolled urination or defecation. According to Dr Mutia, one of two practicing fistula surgeons in Zamfara, Nigeria, “fistulas can happen to anyone, but are most common among young women whose pelvises aren’t at full capacity to accommodate the passage of a child.” In the development community, studies have shown that child marriage is also linked to poverty. Rachel Vogelstein, a Fellow for Women and Foreign Policy at the Council on Foreign Relations, states that “Recent research suggests that families in crisis situations are more likely to marry their daughters early, either to preserve resources by offloading economic responsibility for their girl children or in an attempt to ensure their daughters’ safety from conflict-related sexual violence.” Clearly, child marriage is a complex issue.

Although the number of global child marriages is declining, rates are staggering in countries like Chad, Niger and the Central African Republic. More than two out of every three girls are married before eighteen. Roughly half of the girls married early in Niger do so before turning fifteen. Since there is no magical solution to child marriage, combined efforts may help women and girls lead healthy and successful lives. The goal is to help African societies fully comprehend the seriousness of the issue.


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