Online Program

Mapping telecommunications coverage at public health facilities in Kano State, Nigeria

Tuesday, November 3, 2015

Michael Egwim, Department of Geographic Information Systems (GIS), eHealth Africa, Kano, Nigeria
Kehinde Adewara, Department of Geographic Information Systems (GIS), eHealth Africa, Kano, Nigeria
Dami Sonoiki, Department of Geographic Information Systems (GIS), eHealth Africa, Kano, Nigeria
Nikhil Patil, MPH, Department of Research & Evaluation (R&E), eHealth Africa, Kano, Nigeria

Access to telecommunications networks at health facilities is crucial to the implementation of mobile health (mHealth) systems that facilitate health care and access to health-related information. Poor telecommunications network coverage is a barrier to communication during medical emergencies such as disease outbreaks, obstetric complications, etc., which could have significant implications on health outcomes, particularly in low-resource settings.


The aim of this study is to critically assess the spatial distribution and quality of telecommunications coverage at public health facilities across Kano State by two major telecommunications service providers in Nigeria. The primary objective is to identify health facilities with poor-to-no network coverage between the two providers.


An existing data set on public health facility locations in Kano State was merged with data on receiver base stations (i.e. cells) from Etisalat and Airtel, two major telecommunications service providers in Nigeria. Geographic coverage was determined based on network radius; coverage quality was spatially determined using antenna signal strength, type of radio frequency, and other variables including surface terrain, topography, and weather elements. Using geographic information systems (GIS) tools, the two data sets were overlayed to identify coverage and signal strength at the health facility level.


Out of 1145 public health facilities in Kano State selected for this analysis, 17% had strong Airtel network coverage, 68% had weak coverage, and 15% had no coverage. Under Etisalat, 16% had strong network coverage, 83% had weak coverage, and 1% had no network coverage. When network coverage for Airtel and Etisalat was combined, 12 health facilities did not have any network coverage.


Telecommunications access and quality of coverage is critical to health practitioners' ability to create effective health service delivery programs in Kano State, Nigeria, and elsewhere. A strong telecommunications infrastructure is a pillar that is essential for mobile health interventions to thrive, especially at scale.

Learning Areas:

Other professions or practice related to public health
Program planning

Learning Objectives:
Define telecommunications coverage Demonstrate how to use geographic information systems (GIS) to measure telecommunications coverage Describe the importance of telecommunications coverage for health service delivery

Keyword(s): Geographic Information Systems (GIS), Telehealth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Department Manager for Research and Evaluation at eHealth Africa. I manage an annual budget of approximately $250,000 and am the co-principal on multiple grants focused on polio eradication, health services delivery, and maternal and child health. I have a masters of public health (MPH) and 3+ years of research field experience. Among my scientific interests has been the application of geographic information systems (GIS) for improving healthcare in low-resource settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.