This presentation was delivered by Dr. John Ulimwengu, ReSAKSS Africawide Coordinator.

1. Assessing Community Vulnerability
to COVID-19 in Malawi: A Spatial
Outlook
Dr. John Ulimwengu, Africawide ReSAKSS Coordinator
With analysis by Dr. Greenwell Matchaya, Sibusiso Nhlengethwa, Léa Magne Domgho
April 28, 2021

2. Outline
I. Community vulnerability analysis
• Introduction
• Methodology
• Findings
• Conclusion
• Implications
II. Effects of Covid-19 on micronutrient demand

3. I. Community vulnerability analysis
Introduction (1)
• The impacts of crises are especially severe in areas where chronic
vulnerability is high.
• Understanding patterns of vulnerability is thus of major importance
to guide strategies to prepare for and respond to crises.
• Our goal is to identify areas which, if affected by Covid, would have
the least capacity to absorb shocks and would face the most serious
consequences.
3

4. Introduction (2)
• This study focuses on differentiated spatial vulnerability in Malawi
using an overlay of indicators:
• Susceptibility to the spread of the disease: Population density; disease burden
• Inability to care for infected people: Health infrastructure
• Existing food and nutrition insecurity: Child undernutrition, food consumption
• Due to limited resources, the most vulnerable communities should be
prioritized in crisis prevention and mitigation efforts.

5. Methodology (1)
• The study used 3 Administrative Regions of
the country and all the 28 Districts therein
(2019)
I. Northern
II. Central
III. Southern
• The 28 districts are:
• Northern Region: Chitipa, Karonga, Likoma, Mzimba,
Nkhata & BayRumphi
• Central Region: Dedza, Dowa, Kasungu, Lilongwe,
Mchinji, Nkhotakota, Ntcheu, Ntchisi & Salima
• Southern Region: Balaka, Blantyre, Chikwawa,
Chiradzulu, Machinga, Mangochi, Mulanje, Mwanza,
Neno, Nsanje, Phalombe, Thyolo & Zomba

6. Methodology (2)
Various data sources were considered:
Variable Description DATA SOURCE
hfa2 Height-for-age (Prevalence of stunting)
Demographic and Health Survey
(DHS) 2017
Wfa2 Weight-for-age (Prevalence of Underweight) (DHS) 2017
Wfh2 Wight-for-height (Prevalence of wasting) (DHS) 2017
diab Prevalence of diabetes (DHS) 2017
bloodp Prevalence of high blood pressure (DHS) 2017
Assis_pp
Proportion of females (15-49) getting assistance from doctor,
nurse/midwife, (DHS) 2017
medhelp_disthf
Proportion of females (15-49) for whom distance to health facility
is a big problem (DHS) 2017
pcfood Food expenditure per capita Malawi Housing Census (2018)
density_pop_sup Density of inhabited areas (estimated through remote sensing) Malawi Housing Census (2018)

7. Findings (1): Country vulnerability index
• The composite vulnerability index
suggests that chronic vulnerability is
highest in the Southern Region and
lowest in the Northern Region.

8. Findings (2): Stunting
• The prevalence of stunting is highest in 9
districts (Dedza, Neno, Mchinji, Zomba
Rural, Ntcheu, Mangochi, Mzimba,
Lilongwe Rural and Ntchisi).
• 6 districts (Likoma, Blantyre City, Karonga,
Zomba City, Lilongwe City, and Mzuzu City)
have lower proportions of stunting and are
hence considered much less vulnerable

9. Findings (3): Food consumption per capita
• 8 districts (Mulanje, Machinga, Thyolo,
Nsanje, Chikwawa, Chradzulu, Chitipa,
and Phalombe) spend the least on
food and are considered much more
vulnerable.
• These are mostly Southern region
districts.

10. Findings (4): Access to health services
• Nsanje, Mangochi, Salima, Nkhotakota, Ntcheu, Mzimba,
and Lilongwe Rural districts have very low proportions of
women receiving assistance from a medical professional
during birth.
• Lilongwe Rural, Phalombe, Machinga, Balaka, Mchinji Dowa,
and Neno have the highest proportions of women who stated
that distance was a challenge in accessing healthcare.

11. Findings (5): Disease Burden
• Mzuzu City, Lilongwe City, Balaka, Dowa, Neon,
Thyolo, Nkhatabay and Likoma have higher
proportions of people with blood pressure
problems.
• Mzuzu City, Mchinji, Zomba City, Nkhotakota,
Dedza, Blantyre Rural, Blantyre City, Lilongwe City
and Chikwawa have the highest proportions of
people with diabetes.

12. Findings (6): Population density
• All the cities (Blantyre City, Lilongwe City,
Mzuzu City, and Zomba City) have very
high population densities, thus making
them much more vulnerable to COVID-19
impacts.

13. II. Effects of Covid-19 on micronutrient demand
• Covid-19-related price changes affect nutrition through
their impacts on demand for key micronutrients.
• We estimate micronutrient price elasticities and apply
them to actual 2020 price changes to predict impacts on
micronutrient demand.

14. Price changes in April-November 2020
• Prices of several staple foods
stayed constant or fell
slightly in April-Nov 2020
• Maize prices increased in
urban and rural areas
• This increase followed a
sharp decline in maize prices
in March -10
0
10
20
30
40
50
60
Beans Groundnuts
(shells)
Maize Rice
Malawi food price changes, April-November
2020 (percent)
Urban Rural

15. Existing micronutrient deficiencies
• Households consume close to
the recommended level of
protein, calcium, and iron.
• Consumption of calories and
other key nutrients is
inadequate, especially for
Vitamins B12 and A.
• Deficiencies are more severe in
rural areas.
Note: AME = Adult Male Equivalent

16. Price elasticities of calories and micronutrients
-0,80
-0,60
-0,40
-0,20
0,00
0,20
Calories Protein Calcium Iron Zinc Folate Vitamin B12 Vitamin A
Rural
Cereals & Products Roots, Tubers, and Plantains Nuts and Pulses Vegetables
Meat, Fish & products Fruits Milk and Products Cooked Foods from Vendors
Sugar & sweet Oils and Fats Beverages Spices & Miscellaneous
-0,80
-0,60
-0,40
-0,20
0,00
0,20
0,40
Calories Protein Calcium Iron Zinc Folate Vitamin B12 Vitamin A
Urban
Cereals & Products Roots, Tubers, and Plantains Nuts and Pulses Vegetables
Meat, Fish & products Fruits Milk and Products Cooked Foods from Vendors
Sugar & sweet Oils and Fats Beverages Spices & Miscellaneous
• In most cases, demand
for nutrients falls when
food prices rise
• Demand for calories,
protein and zinc is most
sensitive to changes in
cereals prices
• Demand for calcium,
iron, and vitamin B12 is
especially sensitive to
changes in meat and
fish prices
• Demand for Vitamin A
is sensitive to changes
in vegetable prices

17. Impact of 2020 food price changes on nutrient demand
• Price changes in April-November 2020 are expected to decrease households’
demand for key micronutrients, especially calories, protein, zinc and folate.
• Decreases in demand are larger for rural than for urban households.

18. Key Messages
• The impacts of crises are especially severe in areas where chronic
vulnerability is high.
• Understanding patterns of vulnerability is thus of major importance
to guide strategies to prepare for and respond to crises.
• Our goal is to identify areas which, if affected by Covid, would have
the least capacity to absorb shocks and would face the most serious
consequences.
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19. Key Messages (continued)
• We construct an indicator to measure the level of vulnerability to
serious food security consequences of Covid-19.
• Three components: Susceptibility to the spread of the disease,
inability to care for infected people, and existing food and
nutrition insecurity.
• We identify areas of particular concern where governments should
focus crisis monitoring and mitigation efforts.
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20. Key Messages (continued)
• Changes in price during 2020 modestly affected consumption of key
micronutrients, including calories, protein, zinc and folate.
• Even small changes could exacerbate existing micronutrient
deficiencies.
• Effects were larger in rural areas, which also suffer from greater
existing micronutrient deficiencies.
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21. THANK YOU
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