for example, might become more apparent using GIS. Also, the importance of presenting information on easily readable maps for decision-making purposes was mentioned. Questions remain about the practicality of GIS, however, particularly in light of data quality demands. Each health facility at which supplies are obtained would have to be geocoded. Furthermore, each household participating in the survey would need to be geocoded--a prospect that may raise confidentiality issues. Some participants were concerned that the accuracy of the geocoding would be unacceptable, given the absence of reliable maps in some areas. Finally, it was pointed out that the amount of time it would take to answer questions using GIS would depend on the data systems that were in place--systems that can be built from scratch or by addition to already existing ones.
CLIENT, SERVICE-BASED RECORDKEEPING
Gabriel Ojeda discussed the history of PROFAMILIA and the use of service statistics in PROFAMILIA's clinics in Colombia. PROFAMILIA is a nonprofit family planning organization affiliated with the International Planned Parenthood Federation. There are 49 PROFAMILIA clinics in Colombia that serve 70 percent of couples who use modern methods of contraception. Using standardized definitions--a necessary criteria for accurate nationwide tracking--each of PROFAMILIA's 49 clinics collect data such as the number of new acceptors, follow-up visits, sterilizations, and contraceptives distributed. This information is recorded on the appropriate standardized form and collected by the central
PROFAMILIA office each month. These service statistics, which measure volume, coverage, and quality of services, contribute to the decision-making process of PROFAMILIA clinics on both local and national levels.
Roger Rochat began by reiterating the issues raised in the first session--the importance of using maps to display data spatially. He noted that the Georgia State Health Department has used state maps overlayed with public health data to help policy makers “see ” the spread of rabies, syphilis, and child abuse. In addition, Rochat discussed the ways in which state vital registration data has been linked with the state's Supplemental Nutrition Program for Women, Infants, and Children (WIC) data to determine the proportion of live births, fetal deaths, and induced abortions to mothers in the WIC program. The addition of a family planning element to the already existing WIC programs was an important result of this data linkage research.
The discussion began by focusing on the uses and importance of service data. Ojeda pointed out that the uses of the service data in PROFAMILIA were identified before collection of the statistics began--to serve as an independent guide to decision making at the local and national levels of PROFAMILIA. The service data have also been compared with results from Colombia's Demographic and Health Surveys (DHS) to assess PROFAMILIA's performance and to determine if clinics should be expanded or condensed. The ability to link service data with vital records in the United States underscores the different capabilities in the developed and developing countries; in the latter, such statistics are not always available. In addition, the importance of the standardization of definitions within and among service points (e.g., clinics) was highlighted.