Demography, access to healthcare, and movement all play a role in determining each country’s ability to navigate the pandemic. Dalberg Research’s Location Analytics (LOCAN) database and derived vulnerability index aid in ensuring that help is reaching the places it is needed most, and measures are designed to address the specific challenges that each nation faces.

In the context of Covid, it is widely understood that vulnerable countries and communities require stronger protection measures, and in many cases, more assistance in combating the disease. But how is vulnerability determined, and how can each country’s specific gaps be filled in a way that works for their local context? 

Dalberg Research set out to answer these questions as part of its work on vulnerability and asset mapping of health facilities for six countries in West Africa, as an element of its partnership with The Rockefeller Foundation. As part of a broader collaboration that also included Dalberg Advisors and Dalberg Design, the team set out to determine the factors that make a country vulnerable to the spread of the virus, map the healthcare assets available, and apply mobility analysis to help support national-level Covid response efforts. 

A map of The Gambia shows how vulnerable different areas are to the spread of Covid-19

LOCAN is the most comprehensive geo-spatial database in East and West Africa and was developed by Dalberg Research. Using LOCAN as a starting point, a vulnerability index was created, which reports on regional-level indicators, including population, market, and health facility density, nighttime light intensity, toilet sharing, lack of handwashing facilities, road density, agricultural productivity and more. This index served as a custom snapshot of the potential trigger areas for each nation. 

The team was able to show the various indicators related to COVID spread across the countries, as well as generate an index to calculate the compounded risk at the regional level. The indexing of risk allowed for many factors to be taken into consideration, building out a picture of the overall risk that can be mapped out across a given place. 

A visual representation of average travel time to health facilities in Mali

Through the LOCAN-derived vulnerability index, the Dalberg team had the location-based insight they needed to recommend short- and medium-term interventions aimed at stemming the spread of the virus, and provide embedded operational support to follow up on the implementation of the action plan, mobilize resources, coordinate with partners, and more effectively carry out the daily operations of the Public Health Emergency Operations Centers (PHEOCs) in the region.

Curbing Epidemiological Spread in the Gambia: Quantifying Vulnerability to Help Contain the Spread

Looking at how LOCAN was utilized in The Gambia shows the risk-indexing approach in action, and demonstrates why a country-by-country approach is required. 

In the example of The Gambia, demography, health, and the vulnerability index all served as points of input, with the following factors taken into account from each area: 

• Demography: Banjul’s high-density urban areas were both a challenge and an opportunity from the perspective of epidemiological spread: On one hand, Banjul has a higher proportion of people over 50 compared to rural areas, meaning a higher proportion of people are more vulnerable. On the other, travel restrictions can be put in place to prevent spread to rural areas should an outbreak in Banjul occur, preventing an uptick in city-based infections from filtering to parts of the country that don’t have as much access to healthcare. But putting such restrictions in place could hamper other public health efforts, such as medical care for pregnant women, who could face tough decisions between fear of infection in health facilities and having a homebirth. 
• Health: The Gambia has a low density of hospitals overall, meaning the country’s healthcare system could easily become overwhelmed. Concern of cross-border spreading from Senegal could increase this burden, as well as the fact that in some districts, there is no access to water or hand-washing stations, and a large proportion of the population shares toilets. 
• Vulnerability index: The combined factors in the index showed that The Gambia’s vulnerability is relatively high, especially in and around Banjul and select other regions across the country, as well as at key crossing points with Senegal. 

As a result of this analysis, the Dalberg team recommended that immediate resource and attention should be directed to highly vulnerable areas.

As a result of this analysis, the Dalberg team recommended that immediate resource and attention should be directed to highly vulnerable areas, which are characterized by dense populations in areas of high economic interaction with poor sanitation amenities and access to few health care facilities. Furthermore, Dalberg recommended that heavy surveillance should be placed at the illegal points of entry to prevent illegal crossings into the country at the border with Senegal. 

Building Capacity With Frontline Officers in Mali: Training Health and Data Officers to Develop an Evidence-Based Strategic Response

In Mali, LOCAN was not only used to gather important data about population vulnerability — frontline officers were also trained on the use of the tools so they could process incoming data and translate it into actionable reports.

Dalberg Research trained the officers on data sourcing and data formats. They also shared knowledge on data preprocessing, demonstrating the spatial methods and tools used to convert datasets into formats that are ready for mapping and analysis. Finally, they showed the officers how to generate vulnerability maps of the Malian population, and helped them learn how to analyze vulnerability in a way that provides a region-by-region classification and shows the risk that different groups of people have for contracting the virus.  

The application of Dalberg Research’s LOCAN database and capacity building in The Gambia and Mali are just two glimpses into the power of data and analysis in determining vulnerability and reducing Covid risk for broad swaths of the population. By implementing them, Dalberg was able to help countries create an of-the-moment base of understanding to help determine the most effective steps ahead.