Community-generated data reveals new insights about gender and maternity care challenges in urban Tanzania

Visits to over 22,000 households in Dar Es Salaam are providing local women with a platform to identify and express health care priorities — and in the process, changing perceptions about the value of data in their communities.

This blog post was published as part of the Data Zetu project. Data Zetu is now an initiative of the Tanzania dLab, a local NGO that promotes innovation and data literacy through a premier center of excellence. For more information about the dLab, visit www.dlab.or.tz. For more information about the Data Zetu project, visit www.irex.org.

This post shares an update on community mapping efforts that were introduced in an earlier post. Read that report here.

Community mapping efforts identified “hotspots” in parts of Tandika and Makangarawe wards in Dar Es Salaam, where some citizens reported the longest travel times of over 40 minutes (green dots) to access sexual and reproductive health services. Women comprised nearly half of the community mappers who collected this information.

Today, International Women’s Day reminds us of the importance of accelerating gender parity in local communities. For the Data Zetu team, this mission involves reducing gender data gaps to give citizens and decision makers access to actionable, hyperlocal information to help inform choices about investments, advocacy, and priorities related to maternal care, access to HIV/AIDS resources, and more.

Having this information collected by ‘’my own people’’ will give me the confidence to speak about the problems that people face in my subward.

— John Frey Masese, Vice Chairperson for Moringe subward

How can community mapping fill gender data gaps?

Humanitarian OpenStreetMap Team (HOT), Data Zetu’s community mapping partner, has spent the past several weeks putting gender and healthcare data on the map in four wards across Temeke District of Dar es Salaam — one of PEPFAR’s priority districts across the country due to its high incidence of HIV/AIDS.

Using a survey developed in collaboration with PEPFAR DREAMS Coordinator for Temeke District (to ensure that the data fills information gaps relevant to fighting HIV/AIDS in this district), local residents have been asked specific questions about maternal and child care, such as access to health care centers and the travel time taken to access health services. Some example questions are:

• Do any of the residents in this house go anywhere to receive advice on sexual reproductive health?
• Do elders and children receive access to free health services?

The survey elicited responses around five categories related to gender and health: maternity care, sexual and reproductive services, pediatric support, emergency care, and family care. (This post mostly focuses on maternity care data; stay tuned for details on how to access the rest of the data!)

Of the 329 community mappers in Temeke District, 47.3% are female. Nearly half of those (46.8%) who are in leadership positions — such as wajumbe or ward/subward offices — are women.

Screenshots of survey questions on health mapping. (‘Ndio’ means yes in Swahili; ‘Hapana’ means no). Community mappers conducted this survey in person using a tool on their phones called OpenMapKit.

In a matter of weeks, community members trained by the HOT team visited 22,882 households in Temeke District to conduct this health care survey thus far. This survey has reached 24 subwards across three wards — Makangarawe, Tandika, and Mbagala — and the team is currently mapping Mbagala Kuu. In the process of collecting this data, information about 28,537 buildings have already been uploaded to OpenStreetMap, a free and open tool dubbedthe “Wikipedia of maps”.

Hyperlocal leaders, called wajumbe (learn more in our previous post), work closely with the community mapping team to conduct the surveys, in order to build trust with inhabitants and ensure that more accurate information is provided. Particularly when discussing access to maternal, sexual reproductive and infant health centres, the trusted presence of a mjumbe can be vital.

In these four wards of Temeke District, Dar Es Salaam (left), community mappers reached 22,000 households in a matter of weeks. In this map, each green dot represents a household. Building footprints can be seen in dark grey in eastern Makangarawe Ward, Temeke District (right).

Women playing a role in filling gender data gaps

Our community mapping efforts highlight the role that women can play in the data revolution. Of the 329 community mappers in Temeke District, 47.3% are female. Nearly half (46.8%) of those who are in leadership positions — such as wajumbe or ward/subward offices — are women. In some subwards, such as these three in Mbagala ward, the majority of mappers were women:

These encouraging statistics demonstrate how community mapping can accelerate gender parity in the production of data that matters for women and girls. The data collection process is providing local women with a platform to express maternal healthcare issues that matter to them. On International Women’s Day, this is an opportunity to reflect on ways to engage women to fill gender data gaps to improve service delivery and advocacy for women and girls.

What does the data tell us?

Early insights reveal actionable information for local communities and leaders. Questions about maternal health care (one of the five categories referenced earlier) yielded some of the most compelling contrasts and stories worthy of further investigation. Here are some of those insights:

Note: This section only considers a small fraction of the dataset. Stay tuned for details about how to access the broader data!

1. Travel time to access maternal health care services varies greatly.

From the data, the time taken to access maternity care has been visualised on the map below. Dramatic travel times to maternity care can be noted in the west of Temeke District, particularly along the river. Speaking with our mappers, they have suggested that mobile clinics or community outreach in these areas would be useful. Maps like these can help government bodies better understand maternal health needs based on current access to facilities.

A map showing the time taken to access maternal health care. Darkest green dots represent the longest time of more than 40 minutes.

2. Disparities exist between maternal health supplies access and cost.

In these maps of Makangarawe ward, in areas where cost is not an obstacle, medicine shortage is. Left: Is there a maternity medicine shortage in your area? Center: Is the cost of maternity medicine high? Right: Is there a lack of maternity staff? Green dots indicate a “yes” response; grey means “no”.

The maps above clearly highlight the challenges facing women in Temeke District. Medicine shortage can be seen to be wide spread, with lack of staff also appear to be a fairly common problem. The cost of maternal healthcare can be seen as a barrier to many women in certain areas. Often in areas where cost is not an obstacle, medicine shortage is. These maps highlight a need to better understand how the Ministry of Health is managing the allocation of medicine in particular areas and where health resources can be redistributed.

3. Maternity care centres are mostly open, with some exceptions.

The data collected for maternity centre opening hours is positive. Only Makangarawe subward, in the west of Makangarawe ward, requires more investigation in relation to opening hours:

Left: In Makangarawe subward (west of the blue line), there are clearly hotspots where citizens say maternal health clinics are not open enough, however, across four wards in Temeke District, most maternal health clinics seem to be open enough (right). Green dots mean that lack of opening hours is a problem; gray dots mean it is not a problem, and white dots denote no response.

What’s next — impact and opportunities

This data is hyper recent, with mapping efforts still wrapping up in the last of the four wards in Temeke District. But even at this very initial stage, we can begin to understand the use cases for this data.

Nearly half of female community mappers (45%) reported a positive change in their perceived value of data in their day-to-day. Crucially, this group includes non-technical specialists, such as wajumbe and subward leaders who have little or no data-specific training.

A community member collecting information on maternal and child health in Moringe subward in Mbagala ward, Dar es Salaam. Photo credit: HOT.

For community members including women:

The community mapping process is meant to build skills — particularly with women and girls — on engaging with data tools as well as valuing data. In a survey we conducted, nearly half of female community mappers (45%) reported a positive change in their perceived value of data in their day-to-day. Crucially, this cohort includes non-technical specialists, such as wajumbe and subward leaders who have little or no data-specific training. This impact, we believe, is an important part of supporting the goals of International Women’s Day and in ensuring that gender data gaps are filled by the people who are most affected by them.

For health, gender, and HIV/AIDS practitioners:

The importance of health mapping lies in the production of interactive community maps which link the geography of the community with the availability and accessibility of health services. Producing maps for maternal and child health care can play a major role on health planning — e.g. aiding decision makers to identify areas in need of improved access to health services by allocating additional health resources to specific wards.

Additionally the HOT team has also mapped the infrastructure (roads) of these four wards in Temeke district, as well as counted the population in these communities. Overlaying different datasets — such as the time it takes to access maternity care with the location of flooding hotspots or population density — can surface latent insights and patterns for decision makers to prioritize investments.

For example, this could be used to prevent disease spread, provide patients with data on the healthcare facilities available to them, or help responders locate nearby healthcare centres needed to treat patients during an emergency e.g. flooding. Data collected on access to sexual reproductive healthcare may also suggest levels of awareness about diseases such as HIV/AIDS. Understanding the length of time and mode of transport needed by vulnerable people (mothers, children and the elderly) will help government officials to allocate resources, develop health standards and improve access to health facilities in certain subwards.

For local decisionmakers:

We spent some time last month with community members who participated in or supported the mapping process in Mbagala ward, and they’re already seeing the great impact and wide range of uses for the data that they generate. Speaking with the Vice Chairperson of Moringe subward, John Frey Mases, he commented that:

The data collected will be of great use because when the community ask for help or for a service to be improved, they will have concrete and accurate information to support their argument.

He continued:

Having this data/ information collected by “my own people’’ will give me the confidence to speak about the problems that people face in my subward… through this, our problems will be presented to Parliament.

They also discussed how this hyperlocal, more timely data can complement the current statistics available, which might not reflect reality in Temeke District’s rapidly changing urban environment.

Opportunities moving forward

After completing the mapping process in Temeke, all of the data will be analysed and brought back to the community so that they can be used for development purposes. This will be done through community meetups together with the local leaders who helped steward this data collection process, as well as with organizations like PEPFAR implementing partners working in Temeke District. More importantly, community members themselves have been introduced to this methodology, so they can continue to update this data when it’s valuable and important to them.

Meanwhile, our attention grows in Mbeya district, where the community health mapping process is being replicated to focus on community access to HIV/AIDS healthcare, according to data gaps identified by the TACAIDS (Tanzania Commission for AIDS) coordinator for the entire Mbeya Region. For instance, mapping there could visualise where communities with low levels of HIV education may be more vulnerable. Community leaders will then be able to advocate for HIV testing centres or mobile clinics for the areas under their jurisdiction.

We’re also excited to begin releasing our community-generated data for others to use in conjunction with their own datasets to inform investment decisions and priorities. This process will take some time as data is finalized and cleaned, but once released it will look similar to the Community Insights open dataset Data Zetu published in 2017. Stay tuned for that!