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Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating
1FHI 360, Washington, DC, USA. wmoret@fhi360.org.
Global Health, Science and Practice
|March 3, 2018
Summary
Developing simple tools to measure economic vulnerability for HIV programs proved challenging. Broad economic vulnerability scales did not accurately capture household status, indicating a need for narrower, context-specific indicators.
Area of Science:
- Socioeconomic Determinants of Health
- Development Economics
- Public Health Interventions
Background:
- Economic strengthening programs require tools to identify and support vulnerable households.
- Existing tools struggle to accurately classify economic vulnerability for HIV and child well-being initiatives.
Purpose of the Study:
- To assess the feasibility of developing simple, valid tools to quantify and classify economic vulnerability in three countries.
- To inform the development of effective data collection instruments for targeted interventions.
Main Methods:
- Cross-sectional surveys in Côte d'Ivoire (n=3,749), Uganda, and South Africa.
- Development and validation of economic vulnerability scales and indices against poverty and HIV risk measures.
Main Results:
- Attempts to create composite scales for HIV-related economic vulnerability were unsuccessful in Côte d'Ivoire.
- A vulnerability index in Uganda showed only modest correlation with a validated poverty measure.
- Tools developed in South Africa did not correlate significantly with validation measures, including HIV vulnerability and poverty.
Conclusions:
- Broad constructs of economic vulnerability are difficult to capture with simple scales.
- Recommend using narrower, program-specific vulnerability definitions and context-specific indicators for targeting.
- Advise against reliance on simplified metrics by policymakers and donors.