SONAR Global – The Lived Experience Lab

SONAR-Global: COVID-19 Vulnerability Assessments

Funder: European Union Horizon 2020

Locations: Global (Bangladesh, Uganda, France, Germany, Italy, Slovenia, Malta, the Netherlands, UK)

Themes: COVID-19, epidemic preparedness, social determinants of health, vulnerability assessment, ethnographic research, health equity

The Challenge

The COVID-19 pandemic highlighted profound inequities in health outcomes across and within countries. While much of the global response emphasised epidemiological modelling and biomedical measures, it became increasingly evident that social, cultural, and economic factors played a critical role in shaping vulnerability to infection, severity of illness, and access to care. These non-medical determinants included poverty, stigma, misinformation, marginalisation, and limited trust in institutions, all of which compounded existing health disparities. To design effective pandemic responses, it was essential to identify and understand these vulnerabilities in diverse contexts.

Project Details

SONAR-Global is an EU Horizon 2020–funded social sciences network established to strengthen preparedness and response to infectious disease outbreaks. As part of this programme, our team developed and implemented a series of COVID-19 Vulnerability Assessments across multiple global sites.

The aim was to generate timely evidence on how social and cultural vulnerabilities shaped pandemic risks and responses, and to provide actionable insights for local, national, and international decision-makers. The project built directly on methodologies previously developed by the team for mapping health vulnerabilities in chronic disease contexts, adapting these for the rapidly evolving challenges of COVID-19.

Methodology

The COVID-19 Vulnerability Assessments combined ethnographic and participatory methods with structured survey tools to capture diverse experiences of risk and resilience during the pandemic.

Qualitative Research

Interviews, focus groups, and rapid ethnographies with community members, healthcare providers, and stakeholders explored lived experiences of the pandemic.

Vulnerability Assessment Tool

A structured instrument was adapted for COVID-19, enabling systematic identification of social, economic, and cultural vulnerabilities across sites (Napier, 2020).

Cross-country Implementation

Assessments were carried out in Bangladesh, France, Germany, Italy, Malta, Slovenia, and Uganda, providing comparative insights into how vulnerabilities manifested differently depending on context.

Stakeholder Engagement

Findings were shared through roundtables, policy briefs, and local dissemination activities to ensure that research informed pandemic responses and reflections.

Findings

The SONAR-Global COVID-19 Vulnerability Assessments generated practical, time-sensitive evidence on how social and cultural factors shaped exposure, access to care, and outcomes. Working with municipal teams, health services, NGOs, and community groups across multiple countries, the project led to concrete changes in service delivery.

Elevated health equity as an operational priority for local health authorities and city leaders
Strengthened multi-stakeholder coordination through local-led regular roundtables linking public health,municipal services, and community organisations.
The Vulnerability Assessment was embedded into preparedness Standard operating Procedures (SOPs) and community-engagement protocols beyond COVID-19”
Led to coproduction of plain-language, multilingual materials and used trusted community channels (faith groups, migrant associations) to lift uptake.
Released open tools and training materials that continue to be used for epidemic preparedness and AMR programmes, sustaining impact beyond the pandemic.

● Elevated health equity as an operational priority for local health authorities and city leaders
● Strengthened multi-stakeholder coordination through local-led regular roundtables linking
public health,municipal services, and community organisations.
● Having trained frontline staff to use the Vulnerability Assessment, the methodology was embedded in preparedness
Standard Operating Procedures (SOPs) and community-engagement protocols beyond COVID-19.
● Led to coproduction of plain-language, multilingual materials and used trusted community channels
(faith groups, migrant associations) to lift uptake.
● Released open tools and training materials that continue to be used for epidemic preparedness
and AMR programmes, sustaining impact beyond the pandemic.

Key Researchers: (The Lived Experience Lab, University College London)

Partners

Findings

The Cities Changing Diabetes (CCD) / Cities for Better Health initiative has generated crucial insights into the drivers of type 2 diabetes in urban settings by integrating quantitative data on the diabetes burden with qualitative understandings of social and cultural vulnerabilities. This research informs the development of targeted and context-specific interventions and strategies to promote improved health outcomes in cities worldwide.

Elevated awareness of diabetes as a major public health challenge in urban areasplacing the issue on the agendas of city leaders and policymakers.
A strengthened multi-stakeholder approach to addressing diabetes, building capacity for collective action.
The development and implementation of over 100 interventions globally tailored to the unique contexts of participating cities. These interventions strategically target key areas such as food systems, physical activity promotion, educational initiatives, and innovative care delivery models, ensuring relevance and effectiveness for the specific populations they serve.
The rigorous research undertaken by Cities Changing Diabetes has yielded over 70 peer-reviewed outputs, including ovel vulnerability indices and foodscape studies
CCD’s evidence-based approach has driven notable policy wins at both national and municipal levels. Prominent examples include reforms in China, Mexico, and Denmark, where CCD research directly informed impactful legislative changes.
The sustained impact of CCD interventions is evident in long-term health gains. For instance, in districts like Tingbjerg, Copenhagen, a remarkable decrease in diabetes prevalence has been observed, bucking national upward trends and highlighting the potential for targeted urban interventions to bend the curve on chronic disease.