Abstract
BackgroundResponse to the coronavirus disease 2019 (COVID-19) pandemic calls for precision public health reflecting our improved understanding of who is the most vulnerable and their geographical location. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya.MethodsGeospatial indicators were assembled to create three vulnerability indices; Social VulnerabilityIndex (SVI), Epidemiological Vulnerability Index (EVI) and a composite of the two, that is, Social Epidemiological Vulnerability Index (SEVI) resolved at 295 subcounties in Kenya. SVI included 19 indicators that affect the spread of disease; socioeconomic deprivation, access to services and population dynamics, whereas EVI comprised 5 indicators describing comorbidities associated with COVID-19 severe disease progression. The indicators were scaled to a common measurement scale, spatially overlaid via arithmetic mean and equally weighted. The indices were classified into seven classes, 1–2 denoted low vulnerability and 6–7, high vulnerability. The population within vulnerabilities classes was quantified.ResultsThe spatial variation of each index was heterogeneous across Kenya. Forty-nine northwestern and partly eastern subcounties (6.9 million people) were highly vulnerable, whereas 58 subcounties (9.7 million people) in western and central Kenya were the least vulnerable for SVI. For EVI, 48 subcounties (7.2 million people) in central and the adjacent areas and 81 subcounties (13.2 million people) in northern Kenya were the most and least vulnerable, respectively. Overall (SEVI), 46 subcounties (7.0 million people) around central and southeastern were more vulnerable, whereas 81 subcounties (14.4 million people) were least vulnerable.ConclusionThe vulnerability indices created are tools relevant to the county, national government and stakeholders for prioritisation and improved planning. The heterogeneous nature of the vulnerability indices underpins the need for targeted and prioritised actions based on the needs across the subcounties.
Highlights
What is already known? ►► Disasters and adverse health events such as epidemics and pandemics disproportionately affect population with significantly higher impacts on the most vulnerable and less resilient communities. ►► Significant health, socioeconomic, demographic and epidemiological disparities exist within Kenya when considering individual determinants, little is known about the spatial variation and inequities of their concurrence
What do the new findings imply? ►► Targeted and prioritised actions that cushion against negative effects on the most vulnerable population are essential to respond to the current COVID-19 pandemic. ►► Need for strategies that address the socioeconomic determinants of health due to high levels of socioeconomic deprivation
Using a wide range of spatially referenced indicators to enumerate a varied range of social constraints and assess risk, we developed three COVID-19-specific vulnerability indices to enumerate social vulnerability, epidemiological vulnerability and a combination of the two indices defined at the subcounty level in Kenya
Summary
►► Need for better quality data to define a robust vulnerability index at a high spatial resolution that can be adapted and used in response to future disasters and adverse health events in the long run. Their impact on human health.[1] Under the umbrella of the global health security agenda, countries have come together to advance a world safe and secure from infectious disease. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya. The heterogeneous nature of the vulnerability indices underpins the need for targeted and prioritised actions based on the needs across the subcounties
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