Geospatial analysis for reproductive, maternal, newborn, child and adolescent health: gaps and opportunities

Reproductive, maternal, newborn, child and adolescent health (RMNCAH) indicators, such as the maternal mortality ratio, often serve as a litmus test for health system performance, because women’s and children’s health lies at the core of any health system.1 The health and survival of women and children does not depend on a single intervention, but on packages of interventions delivered at all levels of the health system. Mapping and tracking RMNCAH therefore captures changes in wider health system performance. But mapping has traditionally been the domain of disease-specific tracking, providing useful, but limited snapshots of progress embedded in vertical intervention mechanisms. Although disease-specific spatial mapping and research are effective ways to identify geographic inequities and to inform service provision, geographic and spatial analyses of RMNCAH have the potential to provide a broader perspective. But such analyses, especially for routine RMNCAH care provision, have been underused despite their potential to inform programmes and policies in low/middle-income countries. This commentary also argues that visualisation of RMNCAH data provides a potent social accountability and decision-making tool. Given the topic’s importance, a supplement on the use of geographic information systems (GIS) in RMNCAH is long overdue.Most geospatial studies in RMNCAH start with the geographical placement of facilities and facility staff—the fundamental infrastructure of all health systems—and the location of communities. Clearly, tackling frequently occurring birth and childhood health emergencies requires accessible, person-centred systems located near the client.2 Previous geospatial studies that have focused on determining access or distance to facilities have benefited from analytical techniques developed in the environmental science and physical geography fields. Few previous studies consider realistic travel over terrain or health facility ‘bypassing,’ where healthcare-seeking clients choose not to use their closest facility. This supplement thus breaks new ground by demonstrating that geospatial analysis has …