First steps in constructing a public health GIS in eastern Indonesia

As part of a broader project for monitoring childhood health, a prototype public health oriented GIS in Makassar, Indonesia is being designed and developed. Makassar, on the island of Sulawesi is the largest city in eastern Indonesia with more than 1.3 million people. The goal is to create a GIS that will assist public health workers in monitoring progress towards the reduction and elimination of childhood diseases and also assist in the management of community health resources. Data on dengue, diarrheal disease, pulmonary disease, and typhoid are geocoded to the puskesmas (community health center) level, which cover one or more of the 147 keluharan (urban village) in Makassar. These data are integrated with locally available demographic and meteorological data to create both a monthly temporal and spatial view of excess cases throughout the city during the years 2008 through 2011. Results thus far show the spatial variation, by puskesmas, of excess typhoid cases and an expected seasonal variation in dengue cases. Two issues emerged during the construction of the GIS. First, puskesmas data quality can vary and must be entered manually along with accompanying demographic data. Second, patients seeking care are not necessarily geographically linked to one puskesmas. Both of these issues can confound interpretation and affect public health resource management. The results and the issues raised have implications for global disease surveillance in rapidly developing countries.