ABCs of ‘Reaching the Unreached’: how mapping roads helped to get life-saving vaccines to children in Africa

After 12 in-country missions in five African pilot countries, with training provided to more than 100 key stakeholders, the Reach the Unreached programme has completed Phase 1 with some positive outcomes as well as a new set of challenges, as outlined by this case study from Chad.

By MapAction and CartONG

Image: Pixabay.

At Point A in a country sit a group of children in a remote village, effectively off the map and therefore disconnected from the health clinic at Point C, only a few dozen kilometres away, that could save their lives. If only a line, a road, could connect the dots, the children could have access to life-saving immunisation. 

Each year, approximately 6 million of the 20 million children born in West and Central Africa miss out on even one dose the most basic Diphtheria-Tetanus-Pertussis (DTP) life-saving vaccines during their first year of life: the so-called ‘zero-dose children,’ according to a working definition widely adopted by UNICEF, the World Health Organisation (WHO) and GAVI – an alliance of vaccine partners – among others. 

Reaching the unreached

The Reach the Unreached initiative, led by UNICEF together with UK humanitarian data charity MapAction, French geospatial charity CartONG and the WorldPop programme at the University of Southampton aimed “to improve child vaccination coverage data by pairing our continuous efforts in strengthening administrative systems and household surveys with innovative AI and frontier data methodologies to provide geolocated vaccination estimates to be used in actionable maps and dashboards” says Niccolo Cirone, Data Specialist, UNICEF Regional Office for West and Central Africa (WCARO). 

The goal was to “strengthen immunisation planning in five pilot countries—Cameroon, Chad, Côte d’Ivoire, Guinea, and Mali—by enhancing the use of geospatial data, improving coordination among national stakeholders, and building long-term capacity,” adds MapAction’s Ant Scott. 

GIS4Health

Experts engaged in accessibility analysis might normally consult a national mapping agency or digital road archive to solve such a riddle. In countries where Google Maps is patchy and national mapping agency data is limited or non-existent, the road network needs to be mapped for the dots to connect. This data is limited, often ringfenced in some way, or simply unavailable. 

The joint teams trained more than 100 personnel across the five countries: the training, provided to local health ministries, CSOs and stakeholders, focused on generic data and Geographic information Systems (GIS) techniques, as well as the application of tools and methodologies developed during the project.

A screenshot from CartONG’s Story Map (see below) depicts roads in Chad. Image: CartONG

View Story Map (in English, by CartONG): Reach the Unreached Initiative (Unicef) Chad

View Story Map (in French, by CartONG): Projet Reach the Unreached (Unicef) Tchad

Closing the gap

The feedback from participants was good and rich in recommendations, partly due to differing levels of previous exposure to GIS technology, mapping and health data. “I’ll use the skills and knowledge acquired to meet the needs of the ministry through the Directorate of Statistics and Health Information,” said one ministry official in Chad following a training workshop in December 2024. 

Another ministry employee in Chad added: “This knowledge will allow me to be more effective in estimating the populations of my areas of jurisdiction, but above all help in the delimitation of those areas. This knowledge will be of great use to me.”

Ultimately the capacity-building efforts highlighted the need for differentiated training, ensuring that both policymakers and technical teams receive the right level of support.

Data headache

Sourcing the right data, whether for population modelling or mapping roads, can be complex. “There were primarily two big challenges,” says Dr Attila Lazar, with the University of Southampton’s WorldPop programme, a project partner responsible for modelling population data: “accessing the best available demographic data sources and receiving geolocation information with these data. Population data at small area scales is sensitive and multiple approvals are required that can be time consuming, delaying construction of population estimates,” adds Dr Lazar. 

The same is true of road data, notes CartONG’s Mathieu Anselmino. “There was simply no data about roads available for the pilot area which is why we used volunteers to source them.” Solutions began to emerge at data harvesting mapathons in Chad using OpenStreetMap (OSM) data to map the Chadian road network late in 2024.

This led to a greater understanding among relevant government agencies of how important this work is to conclude, as illustrated by this CartONG story map

An online toolkit was also created to guide participants sustainably through some of the tools and data compiled during the programme. 

The impact was tangible. “The Cameroon field teams were able to use our zero dose children population estimates confidently, which led to an increase in over 70,000 zero-dose and 100,000 under-immunised children reached,” says Niccolo Cirone, Data Specialist, UNICEF Regional Office for West and Central Africa (WCARO). 

For more details on MapAction’s health programmes, please contact Programme Manager Naomi Morris ([email protected]) or MapAction Member Ant Scott ([email protected])

This work was funded and initiated by UNICEF. It was conducted in partnership with several in-country stakeholders and ministries, as well as CartONG and the WorldPop programme at the University of Southampton.

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Mapping COVID crises with GIMAC

So far, the COVID-19 pandemic has reportedly caused 214 million illnesses and killed nearly four and a half million people worldwide (Google statistics). The impact on the poorest and most vulnerable people is immense, especially where populations are already facing several humanitarian crises. 

Maps and charts showing a breakdown of the number displaced individuals in private accomodation, camps, critical shelters or unknown in Iraq as at 30 August 2020

MapAction has been working with GIMAC (the Global Information Management, Assessment & Analysis Cell) which was set up by several UN agencies and other international bodies to coordinate, collate, manage and analyse COVID-19 related information. The organisation also established a ‘field support’ mechanism, available to 25 countries currently implementing a Humanitarian Response Plan. On the ground, this meant providing technical support to a number of countries already facing significant ongoing humanitarian problems and keen to update their plans in light of Covid-19.

MapAction’s role was initially funded by the H2H network, and saw us assimilating the rapid data collection to provide GIS mapping and spatial analysis to support good decision-making. To do this, one of our team was seconded to the programme for two days a week. 

As well as helping to gather initial data, we also used our GIS skills to provide mapping and other visualisations to countries on an open source basis. 

Our work on the programme is now coming to a close but throughout our time on the programme, we provided extensive geospatial analysis and data visualisation support. Overall we produced and provided around 60 maps and graphics on the impacts of the virus and any secondary shocks, alongside the ongoing humanitarian crises. These included baseline populations, food security levels, public security and educational accessibility.

Fawad Hussain, GIMAC Coordinator, OCHA, said, “MapAction has provided exceptional support to GIMAC and the country teams and it has been a pleasure to work with Matt and other MapAction colleagues.” 

Map showing the variety in the number of commodities being sold in market places in Ethiopia January 2019 to April 2020.

Sahel preparedness mapping with UNICEF

DAKAR, 9 Feb – A severe food crisis is forecast to strike the Sahel region of West Africa later in 2012, potentially affecting 7 to 10 million people in eight countries (Senegal, Mauritania, Mali, Burkina Faso, Niger, Nigeria, Chad and Cameroon). Low rainfall, poor harvests and high food prices are making communities vulnerable to extreme malnutrition. The number of children dying from nutrition-related causes is already estimated at more than 490,000 per year.

MapAction has deployed a team of two volunteers to undertake a mapping preparedness project from the UNICEF regional office in Dakar, Senegal. The team will work with UNICEF information management staff to do preparatory map setup and initial vulnerability maps, with a focus on food security and nutrition.

This is MapAction’s third deployment to the Sahel region. In 2005, our volunteers helped map priority needs in a food crisis in Niger and in 2009 we responded to floods in Burkina Faso.