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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Putting children on the map in West and Central Africa through geo-spatial analysis

UNICEF, CartONG and MapAction are announcing a new partnership in six countries: Cameroon, Chad, Côte d’Ivoire, Guinea, Mali and Nigeria. The ‘Reach the Unreached’ initiative aims to use analysis of geographic information (GIS) to find families that may be overlooked by those providing services such as birth registration and vaccination. 

Opening workshop in Senegal.

When traditional ways of identifying and registering people’s existence fail, such as government census and birth registration, children risk missing out on vital services like vaccination and receiving birth certificates. Africa is home to 91 million children under the age of 5 without a birth certificate, according to UNICEF data. In 2022 in West and Central Africa, 4.4 million children did not receive a single dose of vaccine, out of about 20 million children. Children lacking a legal identity risk not being included in planning for service provision. 

To address the problem, UNICEF is working with partners MapAction and CartONG, humanitarian GIS specialists, to help health ministries and their supporting national partners, make data-informed decisions to vaccinate children and ensure the necessary lifelong health assistance. 

READ ALSO: Ode to a geospatial humanitarian partnership and shared values

LIRE AUSSI: Partenariat Humanitaire Géospatial Et Valeurs Partagées : Un Hymne À L’action

UNICEF aims to provide the six countries with spatial data and GIS tools, namely maps and dashboards. This will help local authorities and stakeholders locate unreached children that do not access basic services. The data can then assist in decision-making for improving health planning, immunisation and birth registration.

Beyond mapping unreached children, the project will focus on different activities in each country. These will include spatial data collection and assessment, with a focus on health catchment areas, as well as the production of maps and data visualisation tools. The methodology will be documented throughout, alongside extensive capacity building, to enhance sustainability of the tools and methodologies developed.

A meeting of stakeholders in Cameroon. Photo: CartONG.

“We are thrilled to embark on this transformative journey, supporting efforts to light the way for the unseen and ensuring every child’s right to health and identity in West Africa through GIS innovation,” says Naomi Morris, Health Programme Manager for MapAction. 

“After several years of fruitful collaboration with UNICEF and MapAction, we are delighted to embark on this new project, which shows once again the transformative role GIS solutions can have in facilitating decision-making, especially in hard-to-reach areas,” adds Marie Beeckman, Project Lead from CartONG.

Once information is available, UNICEF works with local authorities to help the identified unregistered members of those communities to access birth registration certificates, life-saving vaccination and other services. 

So far the work has taken in scoping trips and landscape mapping of stakeholders in Cameroon. The next focus countries will be Côte d’Ivoire and Mali. Later in 2024, MapAction and CartONG will start similar activities in Chad, Guinea and Nigeria.

What is MapAction? Video

Cet article est également disponible en français grâce à notre partenaire CartONG.

Mettre les enfants sur la carte en Afrique de l’Ouest et du Centre grâce à l’analyse géospatiale

This work is supported by UNICEF.

MapAction partners to support COVID-19 vaccine delivery

Administering billions of shots of COVID-19 vaccine around the world is a logistical challenge of unprecedented proportions. It is even more complex in countries lacking basic healthcare infrastructure, cold storage or comprehensive transport networks, or where accurate population information is not available.

Understanding how geospatial analysis can help, MapAction is partnering with other geographic information specialists to help coordinate the delivery of COVID-19 vaccines in 15 low-income countries with acute humanitarian needs. 

The Geographic Information Management Initiative for COVID-19 Vaccine Delivery (GIM Initiative), which launches today, aims to help local partners tackle critical issues such as the selection of distribution sites, the planning of healthcare workers’ journeys to remote locations when no up-to-date maps exist, how to record doses and follow up with vaccinated people, and challenges around accessing the most vulnerable communities, including settlements that aren’t yet mapped. 

MapAction is joined in the GIM Initiative by Alcis, CartONG, Humanitarian OpenStreetMap and iMMAP.