equipment to treat cases such as COVID-19 may become life-threatening for some of the most critical patients (Forbes<sup>8</sup> ).

Additionally, rural accessibility may become critical to ensure social and economic recovery of rural areas postcrisis. Rural accessibility gains have a strong correlation with growth in agricultural production (Limi, You, and Wood-Sichra 2017), school attendance rate ( <mark>Vasconcellos 1997),</mark> and child mortality rates (Gage and Calixte 2006). Strong evidence has motivated governments and financing institutions to prioritize interventions to enhance rural accessibility. In 2006, the World Bank Group developed the Rural Accessibility Index (Roberts, Shyam, and Rastogi 2006) as a metric to support the prioritization of rural roads investment with the aim to close the accessibility gap that most rural areas suffer from.

The methods and calculations used to determine the Rural Accessibility Index have evolved quickly since its inception, and in recent years, driven also with advances in analytics, availability of geo-reference data, and computing power, several new methods have been developed (Transport & ICT 2016; Mikou et al. 2019). To keep these methods simple and straightforward, the calculations of this index and the prioritization of interventions have been focusing on the origin of population, for example, where rural people live, but they do not consider the destination of that access and the facilities to which they are getting access. A few recent studies have demonstrated that calculating accessibility to specific facilities (for example, hospital, water sources, schools, or employment opportunities) using geo-spatial analysis is feasible to support the prioritization of rural investments (Andres et al. 2018; Krambeck et al. 2019; Quiros, Kerzhner, and Avner 2019). Currently, the World Bank is updating some of the methodologies for the Rural Accessibility Index and developing a toolbox to allow road agencies to calculate this index without the need of a geo-referenced Road Asset Management System.

There is evidence that disruptions of road infrastructure due to climate impacts have a tremendous impact on rural accessibility especially when communities lack alternative roads and accessibility is very poor even under non-disaster event conditions (Jenelius and Mattsson 2012; Taylor 2012). Transport disruptions are estimated to produce US$107 billion economic impacts globally, not only on the loss of assets but also mostly because of disruption of trade and loss of business continuities (Rozenberg et al. 2019). Recent studies have scaled down this estimate to rural communities and have developed methods to prioritize interventions to reduce the impact and increase the resilience of the rural transport network (Alegre et al. 2018; Rozenberg et al. 2017). These methods are based on traffic flow and have not fully considered nonmotorized transport and the dramatic effect of disruption to the level of accessibility. In rural areas, where motorized traffic is low (for example, fewer

> 8 <u>https://www.forbes.com/sites/claryestes/2020/04/03/calm-before-the-storm-rural-hospital-workforce-pushed-to-the-breakingpoint-when-treating-covid-19/#549dad573501.</u>

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