Putting Guinea’s reproductive health issues on the map

16 September 2016

The Missing Maps project aims to put the world’s most vulnerable people on the map. There can be few people more vulnerable than a woman in childbirth and her unborn baby.

The Danish, Swiss and British Red Cross are currently working together to support the Guinea Red Cross in developing integrated, high quality programmes, and the Reproductive Health and Rights Programme is one of these. It aims to improve knowledge and access to reproductive health and rights in the Moyenne Guinée region of the country.

The goal of Missing Maps within the context of the programme is to provide the detailed basemaps with which programme staff can effectively carry out a baseline survey to better understand the barriers that exist to accessing reproductive health services, and the prevalence of harmful practices.

Accurate basemaps will also allow for more effective strategic planning around the provision of training and services.

Guinea – A country living and dying with the effects of FGM

In 2015, the West African country of Guinea had the 18th highest maternal mortality rate in the world – 679 deaths in pregnancy or childbirth per 100,000 live births, according to data from the World Health Organisation (WHO). For purposes of comparison, the number for the UK is 9.

One of the most significant contributing factors in this high number of deaths is the prevalence of female genital mutilation in the country. According to UNICEF, 96% of women in Guinea have undergone FGM – the second highest rate in the world, behind only Somalia.

In April 2016, the UN High Commissioner for Human Rights said that, “Although female genital mutilation appears to be decreasing worldwide, this is not the case in Guinea, where this practice is widespread in every region and among every ethnic, religious and social group.”

Risk, rural areas and remote mapping

Because of this widespread practice, many Guinean women are at high risk of suffering complications during childbirth. According to the WHO, certain types of FGM result in an approximately 30% increase in the need for caesarean section, and a 70% increase in incidents of severe blood loss after giving birth. There is also a 15-55% increase in death rates for babies.

In its analysis of global maternal mortality rates meanwhile, the WHO reported that, “Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known.”

It also found that, “poor women in remote areas are the least likely to receive adequate health care,” with poverty, distance, lack of information, inadequate services and cultural practices all being key factors in the reasons for pregnant women not receiving the essential emergency care they need.

Helping to prevent the preventable

To tackle these issues, the Guinea Red Cross’ Reproductive Health and Rights Programme, aims in part to improve access to emergency medical care for women experiencing childbirth complications. It also aims to shift practices and cultural viewpoints regarding FGM, and to improve knowledge, rights and access to reproductive health in key areas of the country.


Community in Labé region. CC-BY-NC-ND British Red Cross, Danish Red Cross and Swiss Red Cross

The programme has been ongoing for several years, with the support of the Swiss and Danish Red Cross, and recently the British Red Cross joined the partnership as it enters a new phase.

In order for this new phase of the project to get underway, a ‘baseline survey’ needs to be carried out to establish current levels of access and knowledge across six sub-prefectures. It will also be necessary to collect data in order to measure change as the project progresses, and upon its conclusion. And that’s where Missing Maps comes in.

A mammoth mapping task

Before the baseline survey could take place, accurate base maps were needed of each area, and these were non-existent. So to carry out the extensive amount of mapping required in a relatively short space of time, the British Red Cross maps team in London turned to the Missing Maps project and Humanitarian OpenStreetmap Team (HOT) .

The team uploaded three projects to the HOT Tasking Manager, with instructions for volunteers to map roads, residential areas, buildings and other geographic features. Each project covered two sub-prefectures, and together covered a mammoth area of 777 square miles – almost 1.3 times the size of Greater London.

In less than two months, all six sub-prefectures have been mapped - an impressive feat, and a testament to the incredible impact that the Missing Maps community can have when it works together. In just the six study areas – remote volunteers mapped 40,734 buildings and 1283 residential areas.

Sous-Prefecture Dionfo Tangali Bodie Mafara Maci Ninguelande Total
Buildings 3435 3056 8370 7754 7972 10147 40734
Residential Areas 90 188 211 315 219 260 1283

Once the map features added by remote Missing Maps volunteers have been validated for accuracy, it will be combined with GPS data on village names and other local information collected as part of the baseline survey, creating a rich basemap that is accessible in OpenStreetMap.

The completed maps will then be available for project staff and volunteers to use throughout the programme, and will provide a vital geographic data source with which to visualise the results from the baseline survey. More importantly, they will play an integral role in implementing systems which will help to ensure that pregnant women experiencing birth complications get the immediate medical attention they need.


Baseline surveying. CC-BY-NC-ND British Red Cross, Danish Red Cross and Swiss Red Cross

Without accurate maps – which can guide to a destination, highlight needs, reveal patterns and track developments - the work of aid and development organisations to save and enhance lives can be made even more difficult. Through the efforts of HOT and the Missing Maps community, large swathes of the world which were previously in shadow have been revealed, and the positive impacts of this are only just beginning to be realised.


The mobile data collection team. CC-BY-NC-ND British Red Cross, Danish Red Cross and Swiss Red Cross

by Chris Glithero, Paul Knight, Kat Hicks