The Centre for AIDS Research
The Geography of HIV/AIDS:
Looking beyond the maps
Mike Clark and Emma Treby
University of
Southampton
University of
Bournemouth
Information, suffocation or application?
Looking beyond the maps
Geography as a driver of understanding versus
Geography as a tool for intervention (behavioural or
non-behavioural)
Geography as distributions of attributes (choropleth
maps!) versus geography as synthesis and spatiality
The geography behind the maps:
Information, action, behaviour
Information and communication (governance)
Information and management
The geography of HIV/AIDS: looking beyond the maps
Looking beyond the maps
A typology of HIV/AIDS mapping
Geography and governance: a role for GIS?
Issues of caution
Participation, adaptivity and AIDS response
The geography of HIV/AIDS: looking beyond the maps
A typology of HIV/AIDS mapping
HIV, AIDS and response
A working typology of mapping
Policy-influencing (informing and attitudinal)
Strategic (targets and monitoring)
Operational (support and supervision)
Community participation
The geography of HIV/AIDS: looking beyond the maps
1. Policy-influencing & attitudinal
Simplistic policy-influence concepts
“If you do that, this is
what will happen to you”
The geography of HIV/AIDS: looking beyond the maps
“OK, in that case
I won’t”
Adding realism to map influence
(after The Theory of Reasoned Action: Ajzen & Fishbein, 1975)
The geography of HIV/AIDS: looking beyond the maps
2. Strategic (targets & monitoring)
The geography of HIV/AIDS: looking beyond the maps
3. Operational (support &
supervision)
Community Health Workers homesteads captured for the Outer West .
Illustrating the clinics or mobiles their respective communities visit.
Although most CHW seem to be within 5km of the clinic
their community uses, it does not confirm their
communities fall within this radius.
Injabula
Msunduzi
Qadi
Legend
^ No clinic/mobile entered(15)
Ngcolosi
*#
*
#
Fredville
Bhekisisa Mobile Point_HS M1&2(3)
Botha's Hill Mobile Point_HS M1&2(1)
Fredville Clinic(9)
Hally Stott
Molweni
*
#
Gigaba Mobile Point_HS M1&2(6)
Halley Stott(2)
*
#
Waterfall
Halley Stott Mobiles 1&2(3)
Hlengisizwe Clinic(7)
Wyebank
")
*#
*
#
*
#
*
#
Peaceville
Mpumalanga
Hlengisizwe
Ntshongweni
Injabulo Clinic_attached to Edendale Hospital(1)
Khayelihle Mobile Point_HS M1&2(4)
Mathebethu Mobile Point_HS M1&2(1)
Mgoqozi Mobile Point_HS M1&2(2)
Mhlabunzima Mobile Point_HS M1&2(12)
X Mobile(?) & Waterfall Clinic(1)
W
WMobile(?) & Wyebank Clinic(2)
X
Molweni Clinic(16)
*
#
Zwelibomvu
Molweni Clinic & Umgababa Mobile(1)
X Mpumalanga & Hlengisizwe(8)
W
WMpumalanga & Peaceville(10)
X
Mpumalanga Clinic(14)
Msunduzi Clinic(23)
Ngcolosi Clinic(15)
Ntshongweni Clinic(9)
Peaceville Clinic(1)
")
*#
*
#
*
#
Qadi Building_KwaMashu Polyclinic(7)
Siyathuthuka Point_HS M1&2(1)
Smangenduku Point_HS M1&2(2)
Vulindlela Store Mobile Point_HS M1&2(2)
WVulingqondo Pre-School(2)
X
kj
Waterfall clinic(1)
kj
Wyebank Clinic(7)
")
The geography of HIV/AIDS: looking beyond the maps
Mapping – The Valley Trust
Zwelibomvu Building_Prince Mshiyeni Polyclinic(3)
Local Council
G Other Clinics in Outer West
related Clinics
G TVT
Buffer of 5km around Msunduzi Clinic
Inner West CHW (106)
South CHW (85 with 20 mistakes)
Planning Units
4. Community participation
P Johnstone & J Ranken (1994)
The geography of HIV/AIDS: looking beyond the maps
A typology of HIV/AIDS mapping
ACCURACY
A working typology of mapping
Policy-influencing (informing and attitudinal)
Strategic (targets and monitoring)
Focus on location
and sampling
Focus on synthesis,
aggregation &
association
Operational (support and supervision)
Community participation
PRECISION
HOW DOES GIS RELATE TO ORGANISATIONS?
The geography of HIV/AIDS: looking beyond the maps
A model of regional governance
The geography of HIV/AIDS: looking beyond the maps
A model of regional governance
A role for GIS?
The geography of HIV/AIDS: looking beyond the maps
A role for information
The geography of HIV/AIDS: looking beyond the maps
A model of national governance
National-level organisation
Provincial-level organisation
Flow of management
targets
District-level organisation
Flow of operational
information
Local-level organisation
The geography of HIV/AIDS: looking beyond the maps
A model of national governance
National-level organisation
Provincial-level organisation
Flow of management
syntheses / maps / models
District-level organisation
Flow of operational
information
?
Local-level organisation
The geography of HIV/AIDS: looking beyond the maps
A model multi-level organisation
Policy informing
Policy level
GIS
Management strategy level
Flow of management
maps / models
Supervision level
Flow of operational
information
Operational level
Operational feedback
The geography of HIV/AIDS: looking beyond the maps
A model multi-level organisation
Policy level
Management strategy level
Location and
sampling
Supervision level
Operational level
The geography of HIV/AIDS: looking beyond the maps
Synthesis,
aggregation &
association
Spatial organisation in practice
Provincial-level organisation
District-level organisation
Local-level organisation
Applying the model: CHW
The geography of HIV/AIDS: looking beyond the maps
CHW information structure
The geography of HIV/AIDS: looking beyond the maps
A spatial structure for
CHWs
The geography of HIV/AIDS: looking beyond the maps
^_
_
^ Hammarsdale-Sterkspruit
Sankontshe
G ^
F
^_ ^_ _
^^__
^_^_ ^_^_
_ _
^
_
^
^^_
^ ^_
^__
^_ G
F
^_
Mpumalanga West ^
_
Mpumalanga East
_
^^_
^_ ^_ ^_ ^_
^_
Mophela
^_
^_
_ ^_
G
F^
^_
^_
^_
_
_
^
^
_
^
_
^
^_
^_
^_
^_
^_^_ _
^
^_
^_
GeorgeDale
Mapping – The Valley Trust
^_
KwaZulu Natal example
The geography of HIV/AIDS: looking beyond the maps
The multi-facilitator model
The geography of HIV/AIDS: looking beyond the maps
The multi-clinic model
Applicable to mobile clinics
or health posts
The geography of HIV/AIDS: looking beyond the maps
Geography and governance
ORGANISATIONAL STRUCTURE
SPATIAL STRUCTURE
Spatial and organisational
structure are inherently and
operationally linked
Information drives the
organisation through these
structures
The geography of HIV/AIDS: looking beyond the maps
Mapping, culture & élitism
The geography of HIV/AIDS: looking beyond the maps
Technology is Power
Power Corrupts
Technology Corrupts
Information Ethics?
Can we be sure,
any more?
The geography of HIV/AIDS: looking beyond the maps
Maps of models of
partial representations
of subjective indicators
of “our” world
Can we be sure,
any more?
The geography of HIV/AIDS: looking beyond the maps
The intellectual/moral contradiction
Elitism
Exclusion
The geography of HIV/AIDS: looking beyond the maps
Efficiency
Engagement
Empowering
Equity
The intellectual/moral challenge
Elitism
Exclusion
The geography of HIV/AIDS: looking beyond the maps
Engagement
Empowering
Equity
Maps, participation & adaptivity
BASELINE
Status & prediction
MODELS/PROCEDURES
Adaptive
management
TARGETS
= Goal setting
MEASURES
= Objective setting
Prediction/scenario/review
= GIS
Where do we want to get
Needed to achieve target
RISK ASSESSMENT
Why might target be missed
INDICATORS
For monitoring target and
performance of measures
The geography of HIV/AIDS: looking beyond the maps
BASELINE
MODELS/PROCEDURES
GOALS
OBJECTIVES
RISK ASSESSMENT
MONITOR INDICATORS
DECISION
SUPPORT
TOOLS
The geography of HIV/AIDS: looking beyond the maps
ENABLING
TECHNOLOGIES
STAKEHOLDER
PARTICIPATION
TOOLS
BASELINE
OBJECTIVES
Options Appraisal
RISK ASSESSMENT
Policy GIS
MONITOR INDICATORS
DECISION TREE ANALYSIS
RULE-BASED / MULTICRITERIA
STATISTICAL / GEOSTATISTICAL
Strategic
GIS
MATHEMATICAL MODELLING
FUZZY MODELLING
BAYESIAN MODELLING
The geography of HIV/AIDS: looking beyond the maps
IMPLEMENTATION PROCEDURES
SCENARIOS
GOALS
WEB ENABLEMENT SOLUTIONS
VISUALISATION
Operational GIS
NETWORKING ENABLEMENT SOLUT
MODELS/PROCEDURES
BASELINE
Community Health Workers homesteads captured for the Outer West .
Illustrating the clinics or mobiles their respective communities visit.
Although most CHW seem to be within 5km of the clinic
their community uses, it does not confirm their
communities fall within this radius.
Qadi
Legend
^ No clinic/mobile entered(15)
Ngcolosi
*#
*
#
Fredville
GOALS
Hally Stott
Molweni
SCENARIOS
Wyebank
OBJECTIVES
Ntshongweni
Zwelibomvu
*#
*
#
*
#
j
k
")
RULE-BASED / MULTICRITERIA
STATISTICAL / GEOSTATISTICAL
Strategic
GIS
MATHEMATICAL MODELLING
FUZZY MODELLING
BAYESIAN MODELLING
The geography of HIV/AIDS: looking beyond the maps
Fredville Clinic(9)
Gigaba Mobile Point_HS M1&2(6)
Halley Stott(2)
Halley Stott Mobiles 1&2(3)
Hlengisizwe Clinic(7)
Injabulo Clinic_attached to Edendale Hospital(1)
Khayelihle Mobile Point_HS M1&2(4)
Mathebethu Mobile Point_HS M1&2(1)
Mgoqozi Mobile Point_HS M1&2(2)
Mhlabunzima Mobile Point_HS M1&2(12)
Molweni Clinic(16)
Molweni Clinic & Umgababa Mobile(1)
Mpumalanga Clinic(14)
Msunduzi Clinic(23)
Ngcolosi Clinic(15)
Ntshongweni Clinic(9)
Peaceville Clinic(1)
Qadi Building_KwaMashu Polyclinic(7)
Siyathuthuka Point_HS M1&2(1)
Smangenduku Point_HS M1&2(2)
Vulindlela Store Mobile Point_HS M1&2(2)
WVulingqondo Pre-School(2)
X
j
k
DECISION TREE ANALYSIS
Botha's Hill Mobile Point_HS M1&2(1)
X Mpumalanga & Hlengisizwe(8)
W
WMpumalanga & Peaceville(10)
X
")
MONITOR INDICATORS
Bhekisisa Mobile Point_HS M1&2(3)
X Mobile(?) & Waterfall Clinic(1)
W
WMobile(?) & Wyebank Clinic(2)
X
*
#
RISK ASSESSMENT
Policy GIS
")
*#
*
#
*
#
*
#
Hlengisizwe
Options Appraisal
*
#
*
#
Waterfall
Peaceville
Mpumalanga
WEB ENABLEMENT SOLUTIONS
Msunduzi
NETWORKING ENABLEMENT SOLUT
Operational GIS
MODELS/PROCEDURES
VISUALISATION
IONSIMPLEMENTATION OROCEDURES
Injabula
Waterfall clinic(1)
Wyebank Clinic(7)
Zwelibomvu Building_Prince Mshiyeni Polyclinic(3)
Local Council
G Other Clinics in Outer West
related Clinics
G TVT
Buffer of 5km around Msunduzi Clinic
Inner West CHW (106)
South CHW (85 with 20 mistakes)
Planning Units
Community Health Workers homesteads captured for the Outer West .
Illustrating the clinics or mobiles their respective communities visit.
Although most CHW seem to be within 5km of the clinic
their community uses, it does not confirm their
communities fall within this radius.
Injabula
Operational GIS
Msunduzi
Qadi
Legend
^ No clinic/mobile entered(15)
Ngcolosi
*#
*
#
Fredville
VISUALISATION
Bhekisisa Mobile Point_HS M1&2(3)
Botha's Hill Mobile Point_HS M1&2(1)
Fredville Clinic(9)
Hally Stott
Molweni
*
#
Gigaba Mobile Point_HS M1&2(6)
Halley Stott(2)
*
#
Waterfall
SCENARIOS
Hlengisizwe
Ntshongweni
Options Appraisal
")
*#
*
#
*
#
*
#
Peaceville
Mpumalanga
Halley Stott Mobiles 1&2(3)
Hlengisizwe Clinic(7)
Wyebank
Injabulo Clinic_attached to Edendale Hospital(1)
Khayelihle Mobile Point_HS M1&2(4)
Mathebethu Mobile Point_HS M1&2(1)
Mgoqozi Mobile Point_HS M1&2(2)
Mhlabunzima Mobile Point_HS M1&2(12)
X Mobile(?) & Waterfall Clinic(1)
W
WMobile(?) & Wyebank Clinic(2)
X
Molweni Clinic(16)
*
#
Zwelibomvu
Molweni Clinic & Umgababa Mobile(1)
X Mpumalanga & Hlengisizwe(8)
W
WMpumalanga & Peaceville(10)
X
Mpumalanga Clinic(14)
Msunduzi Clinic(23)
Ngcolosi Clinic(15)
Policy GIS
Ntshongweni Clinic(9)
Peaceville Clinic(1)
")
*#
*
#
*
#
Qadi Building_KwaMashu Polyclinic(7)
Siyathuthuka Point_HS M1&2(1)
Smangenduku Point_HS M1&2(2)
Vulindlela Store Mobile Point_HS M1&2(2)
WVulingqondo Pre-School(2)
X
j
k
j
k
")
Waterfall clinic(1)
Wyebank Clinic(7)
Zwelibomvu Building_Prince Mshiyeni Polyclinic(3)
Local Council
G Other Clinics in Outer West
related Clinics
G TVT
Buffer of 5km around Msunduzi Clinic
Inner West CHW (106)
South CHW (85 with 20 mistakes)
Planning Units
Strategic GIS
The geography of HIV/AIDS: looking beyond the maps
Operational GIS
Policy GIS
Strategic GIS
The geography of HIV/AIDS: looking beyond the maps
The Centre for AIDS Research
The geography of HIV/AIDS: looking beyond the
maps
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