Expanding Global IR Outreach to Address Postpartum Hemorrhage in Kenya Using Geospatial Analytic Mapping.

Abstract

Purpose: To evaluate postpartum hemorrhage (PPH) and IR service landscapes in Kenya using geospatial analytic mapping for outreach planning.

Materials and methods: Geographic information system (GIS) analysis of Kenya was performed using open-source data sets. Data at the regional and county levels from 2014 to 2018 were collected to evaluate demographics and variables related to PPH and healthcare access. Population risk indices were created based on these data. Detailed multilayered GIS mapping was performed to produce visual data representations of the findings for outreach planning.

Results: From 2014 to 2018, the incidence of maternal hemorrhage in Kenya increased by 38%. Six hospitals in Kenya offer IR services that are required to treat PPH, all located in Nairobi. Relative to other counties, maternal mortality ratios (MMRs) in Nairobi were near the median, falling within standard deviations (SDs) of -0.5 to 0.5. MMRs were highest in the southeastern and northwestern regions of the country, with an increase in SD of 1.5-2.3 and 0.5-1.5, respectively. Risk index and population maps identified high-impact hospitals for IR outreach.

Conclusions: GIS analysis demonstrated disproportionate rates of maternal morbidity and mortality due to PPH in areas without IR capabilities. It proved to be a valuable tool to understand population health and can be leveraged to target global IR services strategically.