Free and simple GIS as appropriate for health mapping in a low resource setting: a case study in eastern Indonesia

Through contextualised training, district and clinic staff acquired skills in spatial analysis and visualisation and, six months after the pilot studies, they were using these skills for advocacy in the planning process, to inform the allocation of some health resources, and to evaluate some public health initiatives.We demonstrated that GIS can be a useful and inexpensive tool for the decentralisation of health data analysis to low resource settings through the use of free and simple software, locally relevant training materials and by providing data collection tools to ensure data reliability.GIS is a powerful tool for improving the understanding of data through visualisation and analysis, and is being increasingly used by public health professionals for planning, monitoring and surveillance [1]. Presenting data in maps can provide more insight than a table of the same data, enabling quick assessments of trends and interrelationships [2]. This capability can assist in targeting public health initiatives [3] as well as evaluating health programs and informing long term planning. Providing equitable minimum health services is a particular challenge in developing countries where health resources and transport infrastructure are often poor [4]. Access to health services is the primary determinant of utilisation of these services [5-7] and GIS tools are being increasingly used to evaluate the distribution of health resources (e.g. [7-11]).Despite this potential, the use of GIS in developing countries is not widespread. There are perceived problems with GIS in low resource settings[12-14]; (i) GIS software can be expensive and complex, (ii) input data are often of low quality but presentation in GIS suggests veracity; and (iii) there may be a low capacity for data analysis with the danger of misinterpretation.Various authors have described the potentially undemocratic nature of GIS and how it can exacerbate power imbalances through disenfranchising those without the ski