Kampala turns data into action against COVID-19 inequalities

Kampala is known for its rolling hills, kafundas (small roadside bars with a fridge, plastic chairs and a speaker blaring music) and street traders selling everything from secondhand shoes to matooke (green bananas) and luwombo (meat stew steamed in banana leaves).

But this year from March to July the way of life has drastically changed in Uganda with COVID-19 restrictions including a nationwide shutdown to slow the spread of infection, prohibition of private car use and public transportation, curfews, store closures and the banning of gatherings. With these measures, Kampala’s ‘rush hour’ streets became deserted and its markets went quiet.

The effects of national shutdown are felt more deeply by disadvantaged groups. The vast majority of residents in Kampala make their living through informal employment which often means they rely on daily trade to feed themselves and their families.

Now, taking a data-based and equity-oriented approach to the COVID-19 response, city authorities have been assessing the susceptibility of local communities to the impact of the virus. They have been collecting data on how COVID-19 impacts equity to guide decision-making and use of limited resources.

In Greater Kampala, over 87% of total employment is informal, according to the Uganda Bureau of Labour Statistics. During the pandemic, informal workers have experienced a high risk of loss of income and livelihood, as well as COVID-19 infection due to trading with close person-to-person contact. Moreover, 50% of residents in the Greater Kampala Metropolitan Area live in slums, comprising only 16% of total land, presenting additional challenges to health protection measures such as physical distancing and stay-at-home orders.

Kampala’s COVID-19 Vulnerability Framework measures exposure in transport hubs, shopping centres, population density, and transactional offices.  It also takes into consideration adaptive capacity, meaning the resources available to the community and to the households in the community. This includes food security, level of income and access to healthcare. And finally, it measures susceptibility, determined by population age and pre-existing medical conditions.

These data points generate the COVID-19 Vulnerability Index, an interactive map displaying COVID-19 vulnerability by parish.

In parallel, as a member of the Partnership for Healthy Cities—a global initiative of WHO, Bloomberg Philanthropies, and Vital Strategies— Kampala received support to implement a surveillance system to track COVID-19 incidence across its population. The system leverages contact tracing data to forecast the likelihood of new cases and clusters similar data trends for further analysis. This real-time data helps city authorities gear limited resources to communities that will be most impacted by COVID-19.

“In the face of rapidly changing conditions, data and scientific evidence are the backbone of the public health response during the COVID-19 pandemic,” says Dr Yonas Tegegn Woldemariam, WHO Representative in Uganda. “There is an urgent need for both local and national authorities to collect data on the acceptability, impact and effectiveness of public health and social measures for COVID-19, and particularly how key measures are affecting subpopulations living in vulnerable circumstances.”

Data gathered will not only help even out inequalities but also help to inform preparedness for reducing the impacts of future health emergencies. (World Health Organization, Avenue Appia 20, 1202 Geneva 27, Switzerland)

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