DRC GIST Strategy - Intervention Analysis

Develop, pilot, and institutionalize comprehensive geospatial training curriculum at Universities of Kinshasa and Lubumbashi to build sustainable in-country capacity for health geospatial applications, addressing the critical shortage of trained personnel in geospatial methodologies within DRC's health sector.

This intervention represents the first comprehensive geospatial health curriculum integrated into accredited DRC universities since 2019, training over 50 health professionals in advanced geospatial methods for disease surveillance and health system strengthening. The training curriculum will be formally adopted by two major universities (Kinshasa and Lubumbashi), establishing sustainable institutional capacity that eliminates dependency on external technical assistance. A MOOC platform will be deployed with training materials accessible nationwide, directly addressing the insufficient geospatial capacity identified as a critical barrier to effective health program implementation. This foundational investment creates a permanent pipeline of skilled analysts who can support evidence-based decision-making across all health programs, from polio eradication to malaria control and routine immunization, ensuring that future campaigns and interventions are grounded in spatial intelligence rather than outdated approaches.

The Ministry of Health has prioritized building national capacity in data science and health informatics as part of its Health System Strengthening Plan 2024-2028. This curriculum directly supports MoH objectives by:

• Creating a pipeline of DRC-trained geospatial analysts who can support polio eradication, malaria control, and routine immunization programs without relying on external consultants
• Reducing long-term costs by building permanent institutional capacity rather than recurring short-term technical assistance
• Establishing DRC as a regional center of excellence for health geospatial analysis, with potential to train professionals from neighboring countries
• Ensuring sustainability beyond donor-funded projects through university-led continuation
• Enabling evidence-based micro-planning for vaccination campaigns and disease surveillance that has historically been limited by capacity constraints

Support ANICNS (Agence Nationale d'Identification de la Population) to develop comprehensive enterprise architecture for the national health georegistry, including updated geospatial base layers with health facility locations, administrative boundaries, and population data for all 26 provinces. Establish the foundation for a nationally-owned, authoritative geospatial data system.

This intervention delivers a complete and validated health georegistry architecture covering all 26 provinces of DRC, establishing the foundation for a nationally-owned, authoritative geospatial data system. It produces a harmonized list of existing data sources and systems, eliminating the fragmentation that has historically hindered cross-program coordination and created conflicting information. Preliminary data registry collaboration and coordination mechanisms will be established between MoH, ANICNS, and implementing partners, while a national data governance and interoperability framework is adopted to enable seamless data sharing across health programs. This creates the essential foundation for accurate spatial targeting of health interventions, directly addressing the poor micro-planning that has been identified as a major barrier to achieving immunization equity. The georegistry addresses the limited geospatial data infrastructure and insufficient mapping capabilities that have compromised program effectiveness, providing all stakeholders with consistent, reliable spatial information for the first time.

DRC's health system has suffered from fragmented, uncoordinated geospatial data systems, with each program (polio, malaria, routine immunization) maintaining separate facility lists and boundaries. This creates:

• Duplication of effort and wasted resources as programs independently conduct facility mapping exercises
• Conflicting data that undermines evidence-based decision-making
• Inability to conduct integrated campaign planning or joint supervision

The Ministry of Health has designated ANICNS as the authoritative source for national geospatial data. Continued support will:

• Establish a "single source of truth" for facility locations, administrative boundaries, and population data
• Enable cost savings of approximately $200,000+ annually by eliminating redundant mapping activities
• Support MoH's commitment to data-driven health planning and equitable service delivery
• Provide the technical backbone for tracking progress toward Universal Health Coverage targets

Develop and deploy a centralized digital platform for tracking and managing health equipment across all 26 provinces, enabling real-time inventory management, utilization monitoring, and equipment sharing optimization. Replace paper-based systems that have led to equipment loss, duplication, and inefficient resource allocation.

This system establishes a comprehensive digital inventory of all health equipment deployed across 26 provinces, addressing the current inability to track valuable assets that has led to significant losses and inefficiencies. It provides real-time visibility into equipment location, condition, and utilization rates, enabling optimization of equipment sharing between health zones to reduce idle assets and maximize utilization. The platform significantly reduces equipment loss and theft through systematic tracking and accountability mechanisms while improving budget planning and procurement based on actual utilization data rather than guesswork. Provincial health divisions are empowered with practical tools to manage assets efficiently, with the system integrated into maintenance schedules to extend equipment lifespan and ensure operational readiness. The intervention is estimated to achieve a 20-30% improvement in equipment utilization and a 15% reduction in procurement costs, while enabling cross-program equipment sharing for integrated campaigns spanning polio SIAs, malaria SMC, and routine immunization outreach activities.

The Ministry of Health has identified poor equipment management as a major contributor to health system inefficiency. Current challenges include:

• Expensive equipment sitting idle in one province while another province has urgent needs
• Inability to track equipment procured through donor-funded projects after deployment
• Frequent equipment loss due to lack of accountability systems
• Budget overruns from duplicate procurement when existing equipment location is unknown

Continued funding will support MoH priorities by:

• Enabling strategic asset management aligned with MoH's Health System Strengthening priorities
• Supporting accountability to both domestic budget and international donors
• Providing evidence for more effective budget allocation and procurement planning
• Facilitating cross-program equipment sharing for integrated campaigns (polio SIAs, malaria SMC, routine immunization outreach)
• Establishing a model for transparency and efficiency that can extend to pharmaceutical and supply chain management
• Generating estimated annual savings of $250,000-$350,000 through improved utilization and reduced losses

Establish a unified national health intelligence system that combines real-time geospatial analytics (ESRI-DHIS2 integration) with a secure, centralized data repository. This comprehensive platform will enable decision-makers to track disease trends, vaccination coverage, cold chain access, and facility performance across all 26 provinces while ensuring data interoperability, sustainability, and government ownership under ANICNS and Ministry of Health structures.

This transformative intervention represents the first integrated national health data system in DRC, combining routine surveillance, campaign data, survey data, and geospatial intelligence in one unified platform. Real-time ESRI-DHIS2 dashboards will be deployed in priority provinces for polio, malaria, and immunization programs, while a centralized repository becomes operational with five or more automated data pipelines from sources including DHIS2, Kobo, ODK, PEV Gestion, and survey platforms. The system enables over 20 ANICNS and MoH staff to be trained and manage the infrastructure independently, with more than 50 provincial staff using dashboards for daily operations and micro-planning. The impact extends across all major health programs: polio AFP case tracking and SIA micro-planning will be optimized with geospatial layers; malaria ITN distribution and SMC campaigns will be spatially targeted to high-burden areas; and routine immunization zero-dose hotspots will be systematically identified and addressed. Cross-program campaign planning becomes possible, reducing coordination costs by 25-30% through shared logistics and integrated approaches. Complete system ownership transfers to ANICNS by month 18, with a government-endorsed data governance framework operational and MoH budget commitment secured for long-term maintenance. The intervention generates estimated annual efficiency savings of $350,000-$380,000 from consolidated systems, while establishing DRC as a regional model for integrated health information systems.

DRC currently operates with severely fragmented health information systems:

• DHIS2 modules for routine data with limited geospatial capability
• Kobo/ODK tools for surveys not integrated with routine systems
• Program-specific vertical databases (polio, malaria, RI operate separately)
• No standardized data governance or sharing protocols
• Delayed outbreak detection due to lack of real-time integrated surveillance

This investment provides transformative value:

• One National Source of Truth: Moves beyond siloed systems to harmonized, cross-program repository
• Real-Time + Historical Integration: Enables both immediate action and long-term trend analysis
• Geospatial Intelligence: Adds ESRI-DHIS2 mapping not available in routine deployments
• Cross-Program Optimization: Shared infrastructure avoids duplication across polio, malaria, immunization programs
• Institutional Ownership: Anchored within ANICNS and MoH, not external partners

Ministry of Health Strategic Alignment:

• Directly supports MoH Health Information System Strengthening Strategy 2024-2028
• Enables evidence-based decision-making for Universal Health Coverage targets
• Provides foundation for domestic resource mobilization through transparent performance tracking
• Establishes DRC as regional leader in health data systems
• Ensures all donor investments (Gavi, Global Fund, BMGF) are preserved and enhanced through integration
• Secures MoH budget commitment of $150,000-$200,000 annually for maintenance

Develop a platform for cross-program geospatial learning and capacity building by establishing a Community of Practice that facilitates knowledge exchange between polio, malaria, immunization, and other health programs. This intervention strengthens the institutionalization of the curriculum developed by KSPH and creates sustainable mechanisms for sharing geospatial methodologies, tools, and lessons learned.

The Community of Practice establishes quarterly cross-program learning workshops that bring together over 60 health professionals from polio, malaria, and immunization programs to share geospatial methodologies and innovations. A shared digital repository of geospatial methods, tools, case studies, and best practices becomes accessible to all health programs, significantly improving collaboration and reducing the duplication of geospatial assessments and analyses that has historically wasted resources. The intervention enhances institutional knowledge retention, preventing the loss of expertise that typically occurs when staff transition to new roles, while enabling standardized geospatial approaches to be adopted across programs for improved data comparability. Peer mentoring networks are established between experienced and new geospatial analysts, accelerating skill development and problem-solving capacity. Documentation of lessons learned from field implementation feeds directly back into the KSPH university curriculum, ensuring continuous improvement and relevance. The Community of Practice strengthens the practical application of academic training by connecting it to real-world program needs, while generating estimated savings of $200,000 or more annually through reduced duplication, shared training resources, coordinated data collection efforts, and common analytical frameworks and tools used across all programs.

The Ministry of Health has identified weak coordination between health programs as a major source of inefficiency. Currently:

• Polio, malaria, and immunization programs independently conduct similar geospatial analyses without sharing approaches or findings
• Valuable lessons learned in one program are not transferred to others
• Staff turnover results in loss of institutional knowledge and repeated mistakes
• No systematic mechanism for coordinating analytical approaches or joint problem-solving

Continued funding supports MoH priorities by:

• Creating efficiency gains through shared analytical frameworks and coordinated data collection
• Building a cohesive national cadre of geospatial health professionals
• Strengthening the sustainability and practical impact of university training programs
• Enabling cross-program campaign planning that reduces logistics costs and improves coverage
• Establishing DRC as a learning organization that continuously improves based on evidence
• Supporting MoH objectives for integrated service delivery and health system efficiency
• Creating networks that will sustain knowledge sharing beyond the intervention period

Establish platforms and foster relationships across Program Strategy Teams (PSTs) to systematically embed geospatial insights into polio, malaria, and routine immunization program strategies. Support Ministry of Health integration of geospatial analysis into health program planning, implementation, and monitoring processes, ensuring that spatial intelligence directly informs strategic decision-making at national and provincial levels.

This intervention embeds geospatial analysis systematically into all PST annual work plans and quarterly reviews, ensuring that spatial intelligence becomes a routine component of program strategy rather than an occasional add-on. Regular geospatial briefings to program leadership enable data-driven strategy adjustments in real-time, while improved spatial targeting for vaccination campaigns identifies previously missed settlements and underserved populations. The result is enhanced decision-making at both national and provincial levels based on robust geospatial intelligence. For the polio program, this means optimized environmental surveillance sites, enhanced AFP case investigation tracking, and improved SIA micro-planning with precision geospatial layers. The malaria program benefits from ITN distribution optimization, integrated SMC campaign targeting, and enhanced seasonal transmission monitoring. Routine immunization gains through strengthened RED-QI micro-planning approaches, systematic zero-dose child cluster identification, and optimized cold chain and facility access mapping. The integration of existing GIST investments into routine program operations demonstrates clear return on investment to program leadership, while measurable improvements in campaign efficiency and equity of service delivery validate the value of geospatial approaches across all health programs.

Despite significant investments in geospatial analysis, there remains a gap between analytical outputs and strategic program decisions. This intervention addresses the critical "last mile" challenge:

• High-quality geospatial analyses are produced but not systematically integrated into program planning
• Program leadership often lacks understanding of how to interpret and apply geospatial insights
• Micro-planning continues to use outdated approaches rather than leveraging spatial intelligence
• Potential for equity improvements through better targeting is unrealized

Strategic Value to Ministry of Health:

• Maximizes return on all previous geospatial investments by ensuring insights drive action
• Supports MoH commitment to equity by identifying and reaching underserved populations
• Enables evidence-based resource allocation, targeting investments where they will have greatest impact
• Improves program efficiency through precision targeting, reducing wasted resources
• Demonstrates clear value proposition for geospatial approaches to program managers and donors
• Creates feedback loops where field realities inform analytical approaches
• Establishes geospatial intelligence as core component of health program strategy rather than optional add-on

Establish a comprehensive national data governance framework with clear roles, responsibilities, and accountability mechanisms across MoH, ANICNS, partners, and donors. Create and operationalize inter-agency Technical Working Groups (TWGs) for data harmonization, develop data protection and sharing policies, and provide targeted capacity building to ANICNS staff to function as the central coordination point for all health data in DRC.

This intervention establishes a national data governance framework that is formally adopted by the Ministry of Health and endorsed by key partners, creating clear structures and accountability for health data management across DRC. Inter-agency Technical Working Groups are established and become functional for geospatial data, routine health data, and survey data coordination, providing structured forums for harmonization and problem-solving. Comprehensive data protection and privacy policies are developed, validated, and operationalized, while data sharing agreements and standards are implemented across programs and partners to enable appropriate collaboration while safeguarding sensitive information. Ethical guidelines for data collection and use are adopted to protect vulnerable populations and ensure research benefits communities, while quality assurance and validation procedures are standardized to improve data reliability. Clear decision-making processes for data investments and priorities prevent duplicate spending and ensure efficient resource allocation. ANICNS staff receive training in leadership, strategic coordination, data governance, technical oversight, and partnership management, transforming the agency into a capable national authority. A steering committee becomes operational with representation from all major stakeholders, and coordination protocols are established between polio, malaria, immunization, and other health programs. This establishes ANICNS as a sustainable coordination hub rather than a donor-dependent parallel system, creating the governance foundation necessary for all other technical interventions to achieve lasting impact.

The absence of clear data governance has been a persistent challenge undermining health system performance in DRC. Current consequences include:

• Conflicting data from different sources causing confusion in decision-making
• Poor data quality due to lack of standardized validation procedures
• Ethical concerns from inadequate data protection frameworks
• Duplication of investments as partners independently develop data systems without coordination
• Weak government ownership due to lack of clear leadership and accountability

This intervention provides foundational support for MoH strategic priorities:

• Institutional Strengthening: Builds government capacity rather than creating parallel donor systems, aligning with MoH sovereignty principles
• Sustainability: Establishes ANICNS as permanent coordination hub that will function beyond any single project or donor
• Efficiency: Reduces waste from fragmented, uncoordinated data investments
• Quality: Establishes standards and accountability mechanisms that improve data reliability for decision-making
• Partnership Management: Creates structured mechanisms for donor coordination, reducing transaction costs for MoH
• Policy Framework: Provides ethical and legal foundation for health data use, protecting citizens while enabling innovation
• Regional Leadership: Positions DRC as model for data governance that can be shared with neighboring countries

Complementary to All Other Interventions: This governance framework is essential infrastructure that enables success of all technical interventions (data repository, ESRI-DHIS2 integration, curriculum development, equipment management). Without clear governance, technical systems cannot achieve sustainable impact.

Expand national data governance structures beyond health to create integrated multi-sector coordination mechanisms for geospatial data and health information. Establish formal partnerships between MoH/ANICNS and key government agencies including Ministry of Planning, National Statistics Institute (INS), Ministry of Education, Ministry of Agriculture, and provincial planning offices. Develop inter-ministerial data sharing protocols, harmonized geospatial standards, and joint technical working groups that leverage health data infrastructure for cross-sector development planning, humanitarian response, and evidence-based policy-making across government.

This intervention creates formal inter-ministerial coordination mechanisms that establish ANICNS and MoH as central nodes in DRC's national data ecosystem, extending beyond health sector boundaries. Joint technical working groups are operationalized with participation from Ministry of Planning, INS, Education, Agriculture, and provincial governments, creating structured forums for data harmonization and shared investment planning. Standardized geospatial data sharing protocols are adopted across government ministries, enabling seamless exchange of facility locations, administrative boundaries, population data, and infrastructure information that currently exist in fragmented, incompatible formats. The governance framework establishes clear value propositions for each sector: education gains access to health facility data for school-based health program planning; agriculture leverages health surveillance data for zoonotic disease monitoring; planning ministries use integrated health-education-infrastructure data for evidence-based resource allocation. Multi-sector data standards are harmonized, eliminating the current situation where each ministry maintains different administrative boundary files and facility lists. Cross-sector emergency response protocols are established, enabling rapid data sharing during humanitarian crises including disease outbreaks, natural disasters, and conflict-related displacement. The intervention positions DRC's health data infrastructure as a national public good that serves development priorities across all sectors, demonstrating government-wide returns on health data investments and creating political support for sustained funding from national budget rather than relying solely on health-specific donor resources.

DRC's development planning suffers from severe data fragmentation across government ministries, with each sector maintaining separate, incompatible data systems that prevent integrated analysis and coordinated service delivery. Current challenges include:

• Health facilities, schools, and agricultural extension centers are mapped separately by different ministries using different coordinate systems and boundaries, making integrated planning impossible
• Population estimates used by health, education, and planning differ by 20-30%, creating conflicting resource allocation decisions
• Humanitarian response to emergencies is delayed because ministries cannot rapidly share facility locations, road networks, and population distribution data
• Investment in health data infrastructure cannot be justified to Treasury when benefits accrue only to health sector

Strategic Value Proposition for Multi-Sector Coordination:

• Maximizes Return on Investment: Health data infrastructure ($2-3M investment) serves education, agriculture, planning, humanitarian sectors, multiplying value 5-10x
• National Budget Justification: When health data serves whole-of-government priorities, Treasury is willing to allocate domestic budget for maintenance and expansion
• Development Efficiency: Integrated data enables coordinated multi-sector interventions (e.g., school feeding programs guided by malnutrition surveillance data) that are 40-50% more cost-effective than vertical programs
• Policy Coherence: Evidence-based policy-making across sectors using harmonized data reduces contradictory policies that undermine development
• Humanitarian Response: Rapid multi-sector data sharing during emergencies saves lives and reduces response costs by 30-40% through better coordination
• Donor Harmonization: Multi-sector governance creates single coordination platform for World Bank, UNDP, UNICEF, and other donors working across sectors
• Provincial Empowerment: Provinces gain integrated data tools for local development planning, reducing dependency on Kinshasa
• Decentralization Support: As DRC devolves power to provinces, integrated data governance enables effective decentralized planning

Ministry of Health Leadership Position: By establishing MoH/ANICNS as convener of multi-sector data governance, this intervention elevates health sector's influence in national development planning, positions Minister of Health as key government leader on evidence-based policy, and creates political capital for health priorities across government.