IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v178y2017icp11-18.html
   My bibliography  Save this article

Sensitivity of measuring the progress in financial risk protection to survey design and its socioeconomic and demographic determinants: A case study in Rwanda

Author

Listed:
  • Lu, Chunling
  • Liu, Kai
  • Li, Lingling
  • Yang, Yuhong

Abstract

Reliable and comparable information on households with catastrophic health expenditure (HCHE) is crucial for monitoring and evaluating our progress towards achieving universal financial risk protection. This study aims to investigate the sensitivity of measuring the progress in financial risk protection to survey design and its socioeconomic and demographic determinants. Using the Rwanda Integrated Living Conditions Survey in 2005 and 2010/2011, we derived the level and trend of the percentage of the HCHE using out-of-pocket health spending data derived from (1) a health module with a two-week recall period and six (2005)/seven (2010/2011) survey questions (Method 1) and (2) a consumption module with a four-week/ten-/12-month recall period and 11(2005)/24 (2010/2011) questions (Method 2). Using multilevel logistic regression analysis, we investigated the household socioeconomic and demographic characteristics that affected the sensitivity of estimating the HCHE to survey design. We found that Method 1 generated a significantly higher HCHE estimate (9.2%, 95% confidence interval 8.4%–10.0%) than Method2 (7.4%, 6.6%–8.1%) in 2005 and lower estimate (5.6%, 5.2%–6.1%) than Method 2 (8.2%, 7.6%–8.7%) in 2010/2011. The estimated trends of the HCHE using the two methods were not consistent between the two years. A household's size, its income quintile, having no under-five children, and educational level of its head were positively associated with the consistency of its HCHE status when using the two survey methods. Estimates of the progress in financial risk protection, especially among the most vulnerable households, are sensitive to survey design. These results are robust to various thresholds of catastrophic health spending. Future work must focus on mitigating survey effects through the development of statistical tools.

Suggested Citation

  • Lu, Chunling & Liu, Kai & Li, Lingling & Yang, Yuhong, 2017. "Sensitivity of measuring the progress in financial risk protection to survey design and its socioeconomic and demographic determinants: A case study in Rwanda," Social Science & Medicine, Elsevier, vol. 178(C), pages 11-18.
    • Handle: RePEc:eee:socmed:v:178:y:2017:i:c:p:11-18
    DOI: 10.1016/j.socscimed.2017.02.001
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617300813
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2017.02.001?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Megan Beckett & Julie Da Vanzo & Narayan Sastry & Constantijn Panis & Christine Peterson, 2001. "The Quality of Retrospective Data: An Examination of Long-Term Recall in a Developing Country," Journal of Human Resources, University of Wisconsin Press, vol. 36(3), pages 593-625.
    2. Xu, Ke & Ravndal, Frode & Evans, David B. & Carrin, Guy, 2009. "Assessing the reliability of household expenditure data: Results of the World Health Survey," Health Policy, Elsevier, vol. 91(3), pages 297-305, August.
    3. Clarke, Philip M. & Fiebig, Denzil G. & Gerdtham, Ulf-G., 2008. "Optimal recall length in survey design," Journal of Health Economics, Elsevier, vol. 27(5), pages 1275-1284, September.
    4. anonymous, 2000. "Brochure helps consumers understand credit laws," Financial Update, Federal Reserve Bank of Atlanta, vol. 13(Jul), pages 1-5.
    5. van Osselaer, Stijn M J & Alba, Joseph W, 2000. "Consumer Learning and Brand Equity," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 27(1), pages 1-16, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Conforti, Piero & Grünberger, Klaus & Troubat, Nathalie, 2017. "The impact of survey characteristics on the measurement of food consumption," Food Policy, Elsevier, vol. 72(C), pages 43-52.
    2. Harttgen, Kenneth & Klasen, Stephan & Rischke, Ramona, 2016. "Analyzing nutritional impacts of price and income related shocks in Malawi: Simulating household entitlements to food," Food Policy, Elsevier, vol. 60(C), pages 31-43.
    3. Stifel, David & Minten, Bart, 2017. "Market Access, Well-being, and Nutrition: Evidence from Ethiopia," World Development, Elsevier, vol. 90(C), pages 229-241.
    4. Hao, Zhuang & Zhang, Xudong & Wang, Yuze, 2024. "Assessing the accuracy of self-reported health expenditure data: Evidence from two public surveys in China," Social Science & Medicine, Elsevier, vol. 356(C).
    5. Thomas, Anne-Claire & Gaspart, Frédéric, 2015. "Does Poverty Trap Rural Malagasy Households?," World Development, Elsevier, vol. 67(C), pages 490-505.
    6. Evans, David K. & Popova, Anna, 2016. "Cost-Effectiveness Analysis in Development: Accounting for Local Costs and Noisy Impacts," World Development, Elsevier, vol. 77(C), pages 262-276.
    7. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
    8. Michel Clement & Anke Lepthien & Tim Schulze, 2016. "Erfolgsfaktoren bei der Vermarktung von Kunst [Success Factors for Marketing of Arts]," Schmalenbach Journal of Business Research, Springer, vol. 68(4), pages 377-400, December.
    9. DeVolder, Russell & Serra-Sastre, Victoria & Zamora, Bernarda, 2020. "Examining the variation across acute trusts in patient delayed discharge," Health Policy, Elsevier, vol. 124(11), pages 1226-1232.
    10. Vlad I. Rosca & Cristina Veronica Partenie, 2018. "A theoretical overview on understanding customer-based brand equity," Journal of Community Positive Practices, Catalactica NGO, issue 4, pages 19-28.
    11. Oliveira-Castro, Jorge M., 2003. "Effects of base price upon search behavior of consumers in a supermarket: An operant analysis," Journal of Economic Psychology, Elsevier, vol. 24(5), pages 637-652, October.
    12. Hai-Anh H. Dang & Trung X. Hoang & Ha Nguyen, 2021. "The Long-Run and Gender-Equalizing Impacts of School Access: Evidence from the First Indochina War," Economic Development and Cultural Change, University of Chicago Press, vol. 70(1), pages 453-484.
    13. William Pyle, 2021. "Russia’s “impressionable years”: life experience during the exit from communism and Putin-era beliefs," Post-Soviet Affairs, Taylor & Francis Journals, vol. 37(1), pages 1-25, January.
    14. Valente, Christine, 2014. "Access to abortion, investments in neonatal health, and sex-selection: Evidence from Nepal," Journal of Development Economics, Elsevier, vol. 107(C), pages 225-243.
    15. Tim R. Holcomb & R. Duane Ireland & R. Michael Holmes Jr. & Michael A. Hitt, 2009. "Architecture of Entrepreneurial Learning: Exploring the Link among Heuristics, Knowledge, and Action," Entrepreneurship Theory and Practice, , vol. 33(1), pages 167-192, January.
    16. Beaman, Lori & Dillon, Andrew, 2012. "Do household definitions matter in survey design? Results from a randomized survey experiment in Mali," Journal of Development Economics, Elsevier, vol. 98(1), pages 124-135.
    17. Romina Boarini & Margherita Comola & Femke Keulenaer & Robert Manchin & Conal Smith, 2013. "Can Governments Boost People’s Sense of Well-Being? The Impact of Selected Labour Market and Health Policies on Life Satisfaction," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 114(1), pages 105-120, October.
    18. de Nicola, Francesca & Giné, Xavier, 2014. "How accurate are recall data? Evidence from coastal India," Journal of Development Economics, Elsevier, vol. 106(C), pages 52-65.
    19. Terese E. Venus & Stephanie Bilgram & Johannes Sauer & Arun Khatri-Chettri, 2022. "Livelihood vulnerability and climate change: a comparative analysis of smallholders in the Indo-Gangetic plains," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 24(2), pages 1981-2009, February.
    20. Homburg, Christian & Klarmann, Martin & Schmitt, Jens, 2010. "Brand awareness in business markets: When is it related to firm performance?," International Journal of Research in Marketing, Elsevier, vol. 27(3), pages 201-212.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:178:y:2017:i:c:p:11-18. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.