Overview
Reliable data on household¡¯s use of health facilities, medical expenses, and access to water, hygiene, and sanitation (WASH) is key, both to understand household living standards and to inform investments in access to health services, equity, and financial protection in low- and middle-income countries (LMICs).
It is why the Living Standards Measurement Study (LSMS) team is developing survey methods, standards and best practices to improve data collection on health and WASH, with a particular focus on phone survey methods, integrated household and facility surveys and out-of-pocket (OOP) healthcare services expenditure, which refers to the amount of money paid directly to the provider with no reimbursement.
To do this work, the LSMS team has partnered with the World Health Organization (WHO), the World Bank¡¯s Health, Nutrition and Population Global Practice (HNP), the Global Financing Facility (GFF) and the Health Emergency Preparedness and Response (HEPR) program.
Work Areas
1. Capturing Household Health Expenditure in LMICs
Measuring OOP health expenditure in LMICs is crucial for understanding the financial barriers to universal healthcare access, as well as understanding the health spending impoverishing risk, as reflected in the United Nations Sustainable Development Goals (SDG), indicator 3.8.2, which refers to a catastrophic OOP health spending.
This data is essential for informing policies to reduce financial hardships, improve equity and guide sustainable healthcare financing strategies for vulnerable populations. However, there is a dearth of best practices to properly capture reliable OOP expenditures, both in person and over the phone.
2. Phone Survey Methods for Health Systems Measurement
Health financial protection and service coverage data benefits from higher frequency measurement through phone surveys, and with our partners, we developed a health service utilization phone survey module that was implemented as part of the LSMS-HFPS in various countries.
Due to the novelty of phone surveys in LMICs, knowledge gaps remain on key survey design elements, such as respondent selection, phone survey mode effects and aggregation and questionnaire design. We implemented survey experiments in Burkina Faso, Ethiopia, Malawi and Uganda, with further experiments ongoing in Sub-Saharan Africa and Asia.
3. Integrated Household and Facility Surveys
This type of surveys offers the potential for a comprehensive view of both service utilization and healthcare system capacity, enabling better identification of gaps and inequities in access to care. The LSMS team is piloting an integrated household and health facility survey, capturing health service, demand and supply in Burkina Faso and Ethiopia.
4. Water, Sanitation and Hygiene?(WASH)
Inadequate water and sanitation contribute to diseases such as diarrhea, which is one of the leading causes of death for children in many developing countries. Expanding access to safely managed water and sanitation services is, therefore, a priority. The inclusion of this indicator in national and global development goals has created a need for regular water-quality monitoring, hence, data on drinking water is essential to monitor progress towards achieving these targets.
The survey methodology work in WASH focuses on comparing objective and subjective approaches to measuring access to safe drinking water. It explores the differences between the two approaches and their implications on data production and measuring wellbeing using the indicators generated through different methods.???
The LSMS team collaborates with National Statistical Offices (NSOs) and the Joint Monitoring Programme of UNICEF and the WHO to enhance the measurement and availability of WASH data through national household surveys.?
Resources
Data
Journal Articles
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Blogs?
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