Volume 38 Number 4 December 2007 309 Recent advances in geographic information systems (GIS) have made possible the spatial analysis of large datasets. The proliferation of GIS software has been accompanied by an increase in use of the systems by governments, businesses, nongovernmental organizations, and com- munity groups to analyze social issues. Potential analyses were initially limited by a lack of spatial data, however, and many development organizations began investing in the collection of such data. For example, numerous sur- veys of health-care facilities now use global positioning system (GPS) technology for georeferencing and map- ping of a country’s health facilities. The increasing availability of datasets that contain geographical identifiers and/or spatial coordinates has created new opportunities to perform spatial analysis within social science and public health research. GIS is now a vital tool in epidemiological surveillance, disaster preparedness and response, food security and famine prevention, and health-care referral systems. Social surveys can also be “spatialized” to analyze survey data in a spatial-geographic framework. The in- creasing use of spatial analysis in survey research, how- ever, raises new threats to respondent confidentiality for survey participants. Because GIS technology is relatively new, reproductive health researchers who work with spatialized data may not be fully aware of the risk of re- spondent reidentification, which can result in accidental breaches of confidentiality. Experts on spatial data ap- plications in the social sciences, including demography and public health, have recently recognized the inherent tension between protecting respondents’ confidentiality and the goals of spatial analysis. 1 Geographers and others have long debated the ethics of geographic information systems (for a review of earlier debates, see Schuurman 2000). The widespread adoption of spatial analysis in social research has led to new and increasing concerns regarding issues of power and influ- ence, access to GIS data and technology, and the social impact of the use of these systems (McLafferty 2004). The realization that mapping survey data creates new risks to respondent confidentiality is relatively recent, however, and thus the ethical issues surrounding the protection of privacy of research subjects in spatialized surveys have yet to receive sustained attention. In a special issue on spatial demography published by the National Academy of Sciences, VanWey and colleagues (2005:15,340) state that “as our capabilities for linking geographic data with survey data improve, we also need to better understand the risks that are being created for disclosure of the iden- tities of respondents, and this type of research is just be- ginning. We are still learning what we do not know.” Ac- cording to McLafferty (2004:51), “the need to protect data confidentiality, while at the same time allowing meaning- ful spatial analysis for research and policy, is one of the thorniest issues to emerge in social applications of GIS.” This article examines these ethical concerns by reflect- ing on some of the issues we faced when we conducted a Confidentiality Concerns with Mapping Survey Data in Reproductive Health Research Jill E. Sherman and Tamara L. Fetters The increasing availability of georeferenced datasets creates new opportunities to perform spatial analysis of social science and public health survey data, but also raises ethical issues regarding the potential for unintended violation of the confidentiality of respondents. This article examines these ethical challenges by reflecting on the experience of a study mapping the facilities that provide abortion-related services in Cambodia. The technique of masking is examined as a potential method for preventing reidentification of respondents in georeferenced surveys. Broader solutions are offered for ways to balance the potentially conflicting goals of spatial analysis and protection of confidentiality. (STUDIES IN FAMILY PLANNING 2007; 38[4]: 309–321) Jill E. Sherman is a doctoral candidate, Department of Geography, University of North Carolina at Chapel Hill, CB#3220, Chapel Hill, NC 27599-3220. E-mail: jes@email.unc.edu. Tamara L. Fetters is Senior Associate for Research and Evaluation, Ipas USA, Chapel Hill, NC.