"This map represents what I know": the power of putting Lubumbashi’s maternal healthcare services on the map

Huddled around A0-size printed maps, over 80 stakeholders and representatives from Lubumbashi’s 11 health zones had lively discussions. Several pairs of hands moved across the maps simultaneously – pointing to health facilities, redrawing boundaries, and scribbling suggestions on sticky notes. It was easy for them to check whether the maps were correct, ITM spatial epidemiologist and researcher Dr Peter Macharia explains: "Because they know their areas like the back of their hand".

In an urban context like Lubumbashi city, the geographic distance between women’s residence and health facilities might be relatively short. Yet, many pregnant women are still not accessing the care they need, which negatively impacts their health and the health of their babies. The four-year UrbanMat project, a collaboration between ITM and École de Santé Publique of Université de Lubumbashi (ESP/UNILU), aims to better understand this issue. Led by Prof. Abel Ntambue, a team of three ESP/UNILU researchers and 25 data collectors spent four months tracking down the nearly 1.000 facilities providing childbirth care in Lubumbashi. Based on the information and GPS locations collected by the team, Peter plotted maps for each of the city’s 11 health zones.

If stakeholders’ knowledge is not incorporated, the maps will not be used. When visiting one of the health zone offices, Peter found an old map that was made several years ago. When asked whether they used it, the staff said no – the map was outdated and therefore not useful. "When they don’t have a voice in creating or updating it, a map just ends up in a dusty corner." Over time, new health facilities open, others close, and administrative subdivisions may shift. Keeping the maps accurate therefore requires a continuous effort, which is unlikely to happen without local ownership.

Looking back on the stakeholder workshop, Peter is hopeful that these maps won’t collect dust: "I think they owned it, and that they feel they are part and parcel of what is being done". Back at his office, the annotated sticky notes are piled on Peter’s desk. Based on the input gathered, he is now updating the maps. Laughing, he says: "I have a lot of work to do based on the changes they want to see!"