Stakeholder perspectives on implementing geographic information systems for leprosy elimination in Pakistan: A qualitative study

Leprosy remains a pressing global health concern, with Pakistan among countries still facing missed and delayed diagnosis. By highlighting elevated risk areas, Geographic Information Systems (GIS) are a cost-effective solution to improve leprosy case detection by guiding targeted interventions to high-risk areas. This study's purpose was to investigate the perceived GIS implementation facilitators and barriers, to support targeted interventions and advance the Zero Leprosy strategy.

Semi-structured interviews were conducted with twelve stakeholders, including local field staff, program managers, and international experts. Thematic analysis was guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) and the Diffusion of Innovation Theory (DOI) to identify facilitators and barriers concerned with GIS implementation for leprosy.

Key facilitators included an integrated multi-disease and pilot-based rollout approach, capacity building activities, offline-capable tools, and improved visibility to drive motivation. Barriers included the limited local capacity in complex GIS data analysis, hybrid digital-manual workflows, historical data lacking GPS, and ensuring feedback and ownership for staff members.

GIS implementation is not only dependent on individual readiness, but also on broader external and organizational facilitators and constraints. This necessitates holistic implementation strategies that recognize the interconnectedness of different parts of the system. Internal capacity building is paramount to address statistical complexity and to build trust, ownership, and independence. As the world moves closer to achieving Zero Leprosy, integrating GIS within a multi-disease approach will be critical to making sustainable progress in combatting neglected tropical diseases.