Deciding what to measure, and how to measure it
The EquityTool you see today is the result of several years of collaborative work by researchers, donors and program implementers, searching for a comparable way to measure the socio-economic status of clients of health clinics. The search was initiated by PSI and MSI, who wished to standardize the way they measured the wealth of the client populations they were serving in different countries.
After considering three alternatives, and pilot testing two of them in six different countries, the Social Franchising Metrics Working Group, hosted at the University of California San Francisco, adopted the use of the full Demographic and Health Survey (DHS) wealth index to measure wealth and developed a toolkit to help NGO programs use it.
By adopting the DHS Wealth Index as a standard measure of wealth, programs could theoretically survey their beneficiaries, and make evidence-based decisions about how to reach those in need. However, the tool proved too unwieldy to be easily used in the field, and too complex for a non-specialist to analyze. The need for a simplified, easy-to-use and accurate tool for wealth assessment was evident.
In 2015, Population Services International (PSI) gathered a panel of experts in the field of wealth measurement and the DHS wealth index together. The panel included representatives from USAID, PSI, Marie Stopes International, Results for Development, BroadBranch, and Metrics for Management (M4M) and was tasked with reviewing alternate approaches to wealth measurement.
The panel discussed several alternative simplification approaches, and ultimately agreed on one index that now serves as the basis for today’s EquityTool. The chosen approach has three priorities:
How is the alternative wealth index created?
To create an alternative wealth index for a specific country, the recent DHS data and wealth index files for a country are downloaded. Data from recent Multiple Indicator Cluster Survey (MICS) conducted by UNICEF may also be used. If recent DHS or MICS data is not available for a country, other nationally representative surveys may be appropriate.
Through our pilot testing and feedback process, several questions were found difficult to answer in the contexts for which this survey is designed (outside of the home). These questions are removed. Then, questions are ordered by statistical importance to the full wealth index, and added to the questionnaire in order, until a sufficient level of agreement is reached between the full wealth index and our simplified index. We ensure that respondents are sorted into the same wealth quintiles by both indices at a level of agreement where kappa >= 0.75. This level of agreement must be achieved when comparing the simplified index to the full index for the national and urban only populations. Occasionally, this method does not produce a reliable index. Any changes to the standard process are described in the country factsheet, available on our Countries page.
Metrics for Management (M4M) has translated this methodology into the EquityTool, which can now be used in three key ways. Data can be collected through a user-friendly web based application, or the questionnaire can be added to an existing survey or integrated into DHIS2.
The EquityTool is free to use and does not require training.
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