FAMILY HEALTH AND WEALTH STUDY INSIGHTS ON WEALTH MEASUREMENT AND - PowerPoint PPT Presentation

FAMILY HEALTH AND WEALTH STUDY INSIGHTS ON WEALTH MEASUREMENT AND CHANGE February 20, 2013

STUDY AIMS  To assess the effect of childbearing patterns on family health and wealth outcomes  Number and timing of births  Role of contraception  Family wealth and health outcomes  Household income, employment  Child schooling, nutrition  Maternal health  To assess using a longitudinal design

FHWS SITE LEADS/DATA COORDINATORS Addis Ababa University Obafemi Awolowo University Assefa Seme Peter Ogunjuyigbe Meselech Roro Abimbola Phillips Assiut University University of Ibadan Omaima El Gibaly Michael Okunlola Ghada Al-Attar Imran Morhason-Bello Nathanael Afolabi Kwame Nkrumah University of Science and Technology University of Malawi Easmon Otupiri Frank Taulo Denis Yar Eddie Malunga Wanangwa Chimwaza Makerere University Fred Makumbi Vivian Zalwango

FHWS ACKNOWLEDGEMENTS (US)  Andreea Creanga  Saifuddin Ahmed  Alain Koffi  Michelle Hindin  Funmi OlaOlorun  Stan Becker  Nadia Diamond Smith  David Bishai  Qingfeng Li  Julia Driessen  Adel Takruri  William Pan  Linnea Zimmerman  Timothee Fruhauf  And the rest of the FHWS team

STUDY DESIGN  Three rounds of observation  Probability sample of families in peri-urban area  Wife of childbearing age (15-49 years)  Husband of childbearing age (20-54 years)  GPS mapping of area (waypoints, households)  Data collection began by Ghana site January 2010  Round 2 approximately 2 years later

MEASUREMENT STRUCTURE AND CONTENT  Household roster on occupants and their characteristics, GPS  Focal woman questionnaire  Background characteristics  Childbearing history, fertility preferences and contraceptive calendar  Child schooling (5 to 24 years) and health history (births in <5 years)  Marital relationship quality, decision-making autonomy  Self-reported health  Focal man questionnaire  Background characteristics  Parity, fertility preferences and contraceptive use  Marital relationship quality, decision-making autonomy  Adult morbidity and self-reported health  Wealth module  Housing construction quality, asset ownership, expenditures in <1 year  Physical assessment  Height, weight of household members  Blood pressure, pulse  Anemia (Ghana, Uganda)

PERI-URBAN FHWS SITES Country Coun Site Sampl ample si e size ze Egypt Waldeya 548 Ethiopia Sebeta 998 Ghana Asawasa 800 Malawi Lunzu 605 Nigeria Ipetumodu 787 Nigeria Akinyele 502 Uganda Wakiso 505 Total 4745

SITES VARIED IN ‘PERI-URBAN-NESS’

TRAINING IS EVERYTHING FHWS Round 2 training for Sebeta site

LEARNING TO TAKE BLOOD PRESSURE, MAPPING AND COMMUNITY SENSITIZATION July 2011 workshop Blantyre, Malawi

PRECISION AND ENTHUSIASM KNUST FHWS Team and some of equipment field staff transported during interviews

PROGRESS TO DATE  Analysis workshops in July 2011 and July 2012  Data sharing and authorship agreements  Gates Institute role is facilitating comparative analyses on pre-defined set of topics  Panel at International FP Conference 2011, Dakar  Each site has autonomy to share data with analysts within and outside  Ghana: Two dissertations  Ethiopia: One dissertation  One year spent on data cleaning and linking rounds  Follow-up rates and who is missed  Analyses underway  Comparative description of 4745 families’ health and wealth  Childbearing patterns and child schooling and nutrition  Childbearing and family wealth  Couple concordance in fertility preferences and contraceptive use  Parity and self-rated health (and gender differences)

Parity Composition among Married Women Aged 15 ‐ 44 in Six FHWS Sites 100% 90% 80% 70% 60% 6+ 4 ‐ 5 50% 2 ‐ 3 40% 0 ‐ 1 30% 20% 10% 0% Ibadan Ife Kumasi Lunzu Wakiso Sebeta

Modern Contraceptiv Modern Contraceptive Pre e Prevalence among Married W alence among Married Women A men Ages 15- es 15- 44 by A 44 b Age Gr e Group acr oup across Six Africa-based FHW ss Six Africa-based FHWS Sit S Sites es 80.0 70.0 e method thod using modern contraceptive me 60.0 % using modern contraceptiv 50.0 Ibadan Ife 40.0 Kumasi Lunzu 30.0 Wakiso Sebeta 20.0 % 10.0 0.0 15-19 20-24 25-29 30-34 35-39 40-44 Ag Age g group

Modern Contraceptive Prevalence among Married Women Ages 15 ‐ 44 by Parity across Six Africa ‐ based FHWS Sites 80.0 70.0 % using modern contraceptive method 60.0 50.0 Ibadan Ife 40.0 Kumasi Lunzu 30.0 Wakiso Sebeta 20.0 10.0 0.0 0 ‐ 1 2 ‐ 3 4 ‐ 5 6+ Parity group

CAPTURING HOUSEHOLD TRANSITORY WEALTH THROUGH AN INDEX ON EXPENDITURES AND NON-DURABLES J. Driessen, P. Ogunjuyigbe, A. Phillips, Q. Li, FHWS Study Team, A. Fatusi, A. Tsui

ANALYSIS OF PERMANENT AND TRANSITORY WEALTH MEASURES  Common use of wealth quintiles from assets assessed in surveys (EDHS)  Wealth measure can be broken down into  Permanent wealth (house, housing quality, vehicle, ownership of durable goods)  Transitory wealth (expenditures on entertainment, eating out, other consumption reflective of ‘middle class’ lifestyle)  Such data are challenging to collect  Proxied with asset ownership of durables and non- durables, expenditures, income, household quality

RATIONALE FOR INDEX CONSTRUCTION  Address overlapping measurement of wealth  Deconstruct household wealth into permanent and transitory components  Create a summative index  Selection of index items  Weights for each item  Dichotomous versus continuous measures  DHS wealth quintiles based on PCA with dichotomous measures  Used principal components analysis

OUTCOMES OF INTEREST  Self-rated wealth  9-step ladder of perceived relative economic status  Satisfaction with current income  4-step rating scale  Aspirational wealth  5-step rating scale of relative well-being in one year

PERCENT DISTRIBUTION FOR SATISFACTION WITH CURRENT INCOME 100% 90% 80% 70% 60% Fully satisfied 50% Rather satisfied 40% Less than satisfied 30% Not at all satisfied 20% 10% 0%

ANALYTIC APPROACH  Regress self-reported economic wellbeing measures on  Permanent wealth index (Fixed Asset Index)  Transitory wealth index (Middle Class Index)  Covariates  Male years of schooling  Number of persons in HH under age 5  Number of persons in HH age 5-14

PCA RESULTS FOR FIXED ASSETS Nigeria/ Sites Ethiopia Ghana MalawiNigeria/Ife Ibadan Uganda Eigenvalue of component 1 4.89 3.27 4.67 2.87 3.40 4.28 % variance explained by component 1 10.4 7.4 14.1 6.2 8.5 10.4 Cronbach's alpha 0.774 0.638 0.758 0.575 0.604 0.710 Range of predicted score (min max) (-3.92 (-4.22 (-2.67 (-5.13 (-4.10 (-3.20 9.78) 6.14) 17.44) 6.12) 11.06) 9.99) % variance explained by component 1 9.0 5.9 12.9 6.1 8.2 13.7 with all fixed asset and middle class index items

EXAMPLE OF FACTOR LOADINGS FOR FIXED ASSET INDEX Nigeria/ Nigeria/ Ethiopia Ghana Malawi Ife Ibadan Uganda Furnishings Has bed 0.12 0.00 0.21 0.21 0.24 0.14 Has table 0.08 -0.03 0.21 0.24 0.27 0.21 Has chair 0.08 0.01 0.19 0.23 0.26 0.19 Has dresser 0.26 0.13 0.17 0.18 0.20 0.23 Has refrigerator 0.29 0.24 0.30 0.30 0.25 0.30 Has landline telephone 0.28 0.04 0.15 0.04 0.14 0.14 Has motorcycle 0.01 0.03 0.06 0.04 0.03 0.06 Has bicycle 0.09 0.01 0.05 0.02 0.07 0.13 Has car/truck 0.20 0.12 0.25 0.26 0.26 0.29 Has horse cart -0.01 0.00 0.03 0.15 ‐‐ ‐‐ Has generator 0.10 0.03 0.07 0.29 0.27 0.20

PCA RESULTS FOR MIDDLE CLASS INDEX Nigeria/ Nigeria/ Sites Ethiopia Ghana Malawi Ife Ibadan Uganda Eigenvalue 3.79 3.60 4.83 3.20 3.30 7.67 % variance explained by component 1 11.2 10.6 15.1 9.4 9.7 22.6 Cronbach's alpha 0.671 0.660 0.755 0.677 0.668 0.522 (-2.67 (-1.57 (-2.12 (-4.09 (-2.70 (-0.93 Range of predicted score (min max) 12.64) 18.15) 11.82) 7.77) 14.61) 23.65)

EXAMPLE OF FACTOR LOADINGS FOR MIDDLE CLASS INDEX Nigeria/ Nigeria/ Sites Ethiopia Ghana Malawi Ife Ibadan Uganda Consumption/expenditure behaviors Spent >$2.5 eating out in last 7 days 0.19 0.30 0.14 0.21 0.10 -0.02 Spent >$10 in last month on clothes/shoes 0.07 0.29 0.14 0.22 0.16 -0.01 Spent >$10 in last month on daily household items 0.19 0.30 0.20 0.30 0.15 -0.01 Spent >$5 in last month on medicines 0.07 0.30 0.14 0.23 0.09 0.01 Spent >$10 in last month on books, newspapers, school supplies and entertainment 0.18 0.22 0.23 0.22 0.16 0.00 Spent >$5 in last month on other products and services 0.12 0.24 0.05 0.22 0.13 -0.01 Spent >$20 in last month on child care 0.13 0.26 0.24 0.20 0.10 0.00 Spent >$15 in last 7 days on food (less amount spent eating out) 0.23 -0.25 0.20 0.07 0.13 0.00 Spent >$10 in last month on utilities 0.28 -0.01 0.25 0.20 0.24 0.01 Paid any amount for taxes last year 0.23 0.26 0.20 0.17 0.15 -0.02 Household has no debt 0.01 -0.16 0.00 -0.06 -0.04 0.00 Household has lent any amount to others 0.05 0.11 0.07 0.11 0.14 -0.01 Household currently has savings 0.18 0.08 0.22 0.14 0.18 -0.01

Red frame indicates statistical significance at 5% level. Adjusted for male education, presence of children and youth in household