Diamond, Ian, Matthews, Zoe and Stephenson, Rob
Assessing the health of the poor: towards a pro-poor measurement strategy , London, UK Institute of Health Sector Development 35pp.
(DFID Health Systems Resource Centre).
Full text not available from this repository.
The problems of measuring the health of the poor are now becoming a priority area for
development agencies. This is not only because of the consensus on equitable health
status as a worthy and agreed goal in itself, but also because of the emerging
understanding of the crucial role that health plays in the production of poverty.
Furthermore, the current impetus for preparing Poverty Reduction Strategy Papers
(PRSPs) requires an effective monitoring and evaluation process to be planned as part
of each country’s strategy.
Much data on the health of the world’s poor is already collected on a regular basis in
developing countries by the Demographic and Health Survey (DHS) programme. More
information on the economic status of individuals in developing countries is also
collected, less frequently and with less standardised questionnaires, by the World Bank
under the Living Standards Measurement Survey (LSMS) programme. Other data on
both health and income or wealth is also available from a range of uncoordinated
sources. So far, the only focused attempt to measure the health of the poor uses DHS
data to track health indicators for different ‘wealth’ groups, where wealth is measured by
calculating household assets and amenities. Using DHS data as the main strategy for
measuring health is the best way forward, given that it is the highest quality and most
standardised scheme of data collection. The DHS is very unlikely, however, to include
income in its questionnaire schedule, so that general agreement needs to be reached on
the asset approach as an appropriate way forward, the alternative being a consistent set
of health questions being included in LSMS surveys.
Apart from undertaking analyses of data which has already been collected, there should
also be supplementary data collection undertaken to cover the shortcomings of the DHS
in any given setting. According to the country characteristics in any given setting, the
following range of techniques should be considered to supplement DHS and LSMS
monitoring: poverty mapping from the most recent census; piggybacking poverty studies
on already functioning population ‘laboratories’; and undertaking new cluster surveys in
new poor areas. It is also advisable to engage in a dialogue for undertaking new
standardised surveys in-country such as DHS and LSMS. The latter is particularly
amenable to flexibility of subject matter to be included in the questionnaire.
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