UHC-Partnership: Geospatial analysis in Lao PDR helps people access better health care services

Kua lives in remote Sa Kuan Village, Luang Prabang Province with her husband Sivong and their four children. The family's village sits in a beautiful but remote and mountainous part of Lao People's Democratic Republic (PDR), several hours from a major road and a more than one-and-a-half-hour drive across rugged terrain to the closest medical facility, Huay Khing Health Centre.

Giving birth at home placed Kua at an increased risk of pregnancy complications with no access to medical support. It was impossible for her to travel safely to the small health centre late in her pregnancy due to significant financial costs and a lack of transport.

Since 2021, Lao PDR has been using geospatial analysis as a powerful tool in the effort to enhance primary healthcare services. The tool maps data for demographic and socio-economic status, the location of health facilities, use of health services, and the available human resources for health.

This data has allowed the Government to improve its strategic planning and resource allocation to improve the accessibility, availability, and quality of health and care services at the primary care level. Improving health infrastructure and the availability of health and care workers encourages trust in health services amongst the population. This approach also provides clear guidance on where further investment is needed to address health inequity issues.

"Lao PDR will be using geospatial analysis to drive decision-making about where to improve and invest in primary health services across the country. It means we can be more strategic and precise about better supporting those communities who need health services the most, leading us purposefully along the path to achieve universal health coverage," said Dr Bounserth Keoprasith, Director General of the Department of Planning and Finance at the Ministry of Health for Lao PDR.

Aiming to improve equity and achieve universal health coverage

The Lao PDR Health Sector Reform Strategy 2021-2030 identifies strengthening primary health care as a critical foundation to achieve universal health coverage (UHC) and other health-related Sustainable Development Goals by 2030. WHO, through the UHC Partnership, supported the development process of the Health Sector Reform Strategy through technical guidance and financial support to organize consultations at central and subnational levels.

While Lao PDR has improved many health targets in the past decades, the Government is putting more emphasis on improving health equity, eliminating communicable diseases, and reducing maternal mortality and under-five mortality rates by improving services for hard-to-reach populations in remote and rural areas.

Mapping for equity and change

All three levels of WHO, through the UHC Partnership, provided support to the Ministry of Health to undertake this comprehensive initiative on geospatial analysis. Initially, a pilot project took place in two provinces with the aim of identifying data to support health planning including the selection of health facilities for investment, closure, or repurposing, and the redistribution of human resources for health at the subnational level.

In 2023, the Ministry of Health used the pilot results to guide further analysis and dissemination and facilitated consultations through two regional workshops with Director-Generals, Deputy Director-Generals, planning focal points, and concerned technical officers from provincial level and central departments. These workshops took place at the subnational level across 17 provinces to improve planning for human resources for health.

"When I participated in the consultation on health planning, it was of huge significance to be able to draw upon the data made available through the geospatial analysis. Although we can all speak from professional experience about health workforce and health facilities challenges, having accurate data available makes our contributions and decision-making more meaningful than ever before," said Dr Viengsy Souphakdy, Director-General of the Provincial Health Office of Champasak Province in Lao PDR.

Geographical data, health attributes data, social determinants of health, and demographic data all provided valuable inputs into the analysis. Geographical data included information about health centres, road networks, and barriers to entry such as bodies of water. Road network data and waterbodies data were gathered from the Centre for Development and environment and Open Street Maps.

"The geospatial analytical approach that the Ministry of Health has taken is very refreshing. Being able to consider and analyse multiple levels of data simultaneously has brought a depth and breadth to our strategic decision-making. In consultation with others working at sub-national level, we are confident this will strongly improve how we manage primary health care," said Dr Phetvongsinh Chivorakhoun, Deputy Chief of the Division of Planning and Budgeting of the Department of Planning and Finance at the Ministry of Health, Lao PDR.

The UHC Partnership operates in over 125 countries, representing over 3 billion people. It is supported and funded by Belgium, Canada, the European Union, France, Germany, Ireland, Luxembourg, Japan, the United Kingdom of Great Britain and Northern Ireland, and WHO.

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