The application of geographical information systems to important public health problems in Africa.

Africa is generally held to be in crisis, and the quality of life for the majority of the continent's inhabitants has been declining in both relative and absolute terms. In addition, the majority of the world's disease burden is realised in Africa. Geographical information systems (GIS) technology, therefore, is a tool of great inherent potential for health research and management in Africa. The spatial modelling capacity offered by GIS is directly applicable to understanding the spatial variation of disease, and its relationship to environmental factors and the health care system. Whilst there have been numerous critiques of the application of GIS technology to developed world health problems it has been less clear whether the technology is both applicable and sustainable in an African setting. If the potential for GIS to contribute to health research and planning in Africa is to be properly evaluated then the technology must be applicable to the most pressing health problems in the continent. We briefly outline the work undertaken in HIV, malaria and tuberculosis (diseases of significant public health impact and contrasting modes of transmission), outline GIS trends relevant to Africa and describe some of the obstacles to the sustainable implementation of GIS. We discuss types of viable GIS applications and conclude with a discussion of the types of African health problems of particular relevance to the application of GIS.