nach oben

Quality of Life Research

Erschienen in:

13.06.2020

Can survey data facilitate local priority setting? Experience from the Igunga and Nzega districts in Tanzania

verfasst von: Malale Tungu, Gasto Frumence, Mughwira Mwangu, Anna-Karin Hurtig, Lars Lindholm

Erschienen in: Quality of Life Research | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed to investigate whether a local survey applying EQ-5D and SAGE could provide data valuable in setting priorities.

Methodology

A cross-sectional household survey was used to collect information from a total of 1,899 elderly individuals aged 60 years and over living in the Nzega and Igunga districts using the WHO-SAGE and EQ-5D questionnaires. QALY weights were generated using the average of an EQ-5D index. A multivariable regression model was performed to analyse the effect of socioeconomic factors and self-rated health status on the EQ-5D index, using a linear regression model.

Results

The confidence interval estimates indicate higher HRQoL among men, married, urban dwellers, and elderly rated with good health than in women, unmarried, rural dwellers, and elderly rated with bad/moderate health, and it decreases with age. Income and education level have a positive relationship with HRQoL. The regression analysis; Model 1 (not adjusted with SAGE variables): age in all groups (p = 0.01, 0.00 and 0.02) and marital status (p = 0.01) have an influence on HRQoL. Model 2 (adjusted with SAGE variables): self-rated health (p < 0.00), the age for the 80–89 group (p = 0.01), marital status (not married), and high income have an influence on HRQoL. Sex, education, and residence were not statistically significant (in either model) to affect the HRQoL of the elderly.

Conclusion

Local surveys, applying a combination of EQ-5D and SAGE, generate relevant and valuable information for policy makers when setting priorities at the district level. Therefore, this paper provides an empirical analysis for decision makers to consider the importance of combining EQ-5D, SAGE, and socioeconomic factors when setting priorities to improve HRQoL among the elderly.

W.H.O. (2015). World report on ageing and health. Geneva: World Health Organization.

World Population Ageing. United Nations, Department of Economic and Social Affairs Population Division (2015) [Internet]. 2015;United Nat((ST/ESA/SER.A/390):164. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf%5Cnwww.un.org/.../population/.../WPA2009/WPA2009.

National Bureau of Statistics (NBS), Office of Chief Government Statistician. (OCGS). Population distribution by age and sex: The United Republic of Tanzania. 2013;471. https://ihi.eprints.org/2169/1/Age_Sex_Distribution.pdf.

Mwanyangala, M. A., Mayombana, C., Urassa, H., Charles, J., Mahutanga, C., Abdullah, S., et al. (2010). Health status and quality of life among older adults in rural Tanzania. Global Health Action, 3(2), 36–44.

Ministry of Labour Youth Development and Sports. (2003). United Republic of Tanzania: National Ageing Policy 2003 (pp. 1–18). https://www.globalaging.org/elderrights/world/2007/BGTanzania.pdf.

United Republic of Tanzania. (2015). Health Sector Strategic Plan July 2015–June 2020. Dar es Salaam: Ministry of Health and Welfare.

Office for National Statistics. (2018). National Population Projections. England: Office for National Statistics.

National Bureau of Statistics (NBS) and Office of Chief Government Statistician (OCGS). (2015). Z. Mortality and Health Report 2015 (Vol. 1, pp. 1689–1699). Dar es Salaam: The National Bureau of Statistics.

United Nations. (2011). Delivering as one social protection in Tanzania. Annual Report 2011.

10.

The United Republic of Tanzania Ministry of Finance, Policy Forum. (2012). Government Budget for Financial Year 2011/2012: Citizens’ Budget Edition (pp. 1–20). Dar es Salaam: Ministry of Finance.

11.

MOF. (2017). The United Republic of Tanzania. Ministry of Finance and Planning Government Budget for Financial Year 2016/2017. Citizens’ Budget Edition. https://www.mof.go.tz/mofdocs/budget/CitizensBudget/CITIZENSBUDGET16-17(English).pdf.

12.

Morisset, J., & Wane, W. (2012). Old and vulnerable: The status of Tanzania’s elders. Washington, DC: World Bank [Internet]. https://blogs.worldbank.org/africacan/old-and-vulnerable-the-status-of-tanzania-s-elders.

13.

URT. (2015). United Republic of Tanzania, Ministry of Finance 2014/2015, Citizens’ Budget Edition (pp. 1–22). Dar es Salaam: Ministry of Finance in Collaboration with Policy Forum.

14.

United Republic of Tanzania. (2016). Ministry of Finance 2015/2016 Citizens ’ Budget Edition (pp. 1–22). Dar es Salaam: Ministry of Finance in Collaboration with Policy Forum.

15.

Bank of Tanzania. (2018). The United Republic of Tanzania. Ministry of Finance and Planning, The Citizens’ Budget, a simplified version of Government Budget for Financial Year 2017/2018 (p. 284). https://www.bot-tz.org/FinancialMarkets/TBonds/TBondCallforTender/2012-JUNE-13-TBOND.pdf.

16.

URT. (2011). Comprehensive Council Health Planning Guidelines 2011. Dar es Salaam : United Republic of Tanzania.

17.

Maluka, S. (2011). Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania opportunities, challenges and the way forward. Global Health Action. https://doi.org/10.3402/gha.v4i0.7829.CrossRefPubMedPubMedCentral

18.

Frumence, G., Nyamhanga, T., Mwangu, M., & Hurtig, A.-K. (2013). Challenges to the implementation of health sector decentralization in Tanzania: experiences from Kongwa district council. Global Heal Action. https://doi.org/10.3402/gha.v6i0.20983.CrossRef

19.

United Republic of Tanzania. (2003). Regional workshop on ageing and poverty, ageing and poverty in Tanzania. Dar es Salaam: United Republic of Tanzania.

20.

Kapiriri, L., Norheim, O. F., & Kapiriri, L. (2004). Criteria for priority-setting in health care in Uganda: Exploration of stakeholders’ values. Bulletin of the World Health Organization, 82(3), 172–179.PubMedPubMedCentral

21.

Baltussen, R., Niessen, L., Ham, C., Robinson, R., Kapiriri, L., Norheim, O., et al. (2006). Priority setting of health interventions: The need for multi-criteria decision analysis. Cost Effective Resource Allocation, 4(1), 14.CrossRef

22.

Osberg, L., & Mboghoina, T. (2010). Social protection of the elderly in Tanzania: Current status and future possibilities. REPOA Brief No. 24. Dar es Salaam: REPOA.

23.

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes (4th ed.). Oxford: Oxford University Press.

24.

Hoi, L. V., Phuc, H. D., Dung, T. V., Chuc, N. T., & Lindholm, L. (2009). Remaining life expectancy among older people in a rural area of Vietnam: Trends and socioeconomic inequalities during a period of multiple transitions. BMC Public Health, 9, 471.PubMedPubMedCentralCrossRef

25.

Bowling, A. (2010). Measuring health related quality of life among older people. Aging & Mental Health, 24, 3–5.

26.

Usman, A., Lewis, S., Hinsliff-Smith, K., Long, A., Housley, G., Jordan, J., et al. (2018). Measuring health-related quality of life of care home residents, comparison of self-report with staff proxy responses for EQ-5D-5L and HowRu: Protocol for assessing proxy reliability in care home outcome testing. British Medical Journal Open, 8(8), e022127.

27.

EuroQol Research Foundation. (2018). EQ-5D-3L user guide: Basic information on how to use the EQ-5D-3L instrument (p. 9). www.impact-test.co.uk.

28.

World Health Organization. (2014). Study on global AGEing and adult health (SAGE) Wave 1 Mexico National Report. WHO Sage 1. Cuernavaca: Instituto Nacional de Salud Pública (INSP).

29.

Kowal, P., Kahn, K., Ng, N., Naidoo, N., Abdullah, S., Bawah, A., et al. (2010). Ageing and adult health status in eight lower-income countries: The INDEPTH WHO-SAGE collaboration. Global Health Action, 3(Suppl. 2), 11–22.

30.

National Bureau of Statistics (NBS). (2017). Tanzania in figures 2016. Dar es Salaam: The National Bureau of Statistics.

31.

Jelsma, J., Hansen, K., de Weerdt, W., de Cock, P., & Kind, P. (2003). How do Zimbabweans value health states? Population Health Metrics, 1(1), 11. https://doi.org/10.1186/1478-7954-1-11.CrossRefPubMedPubMedCentral

32.

Drummond, M., et al. (2005). Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press.

33.

Murray, C. J. L., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from deceases, injuries and risk factors in 1990 and projected to 2010. Harvard School of Public Health, 1, 1–35.

34.

Whitehead, S. J., & Ali, S. (2010). Health outcomes in economic evaluation: The QALY and utilities. British Medical Bulletin, 96(1), 5–21.PubMedCrossRef

35.

Hanmer, J., Feeny, D., Fischhoff, B., Hays, R. D., Hess, R., Pilkonis, P. A., et al. (2015). The PROMIS of QALYs. Health and Quality of Life Outcomes, 13(1), 15–17. https://doi.org/10.1186/s12955-015-0321-6.CrossRef

36.

Wonderling, D., Gruen, R., & Black, N. (2005). Introduction to health economics. London: Open University Press.

37.

Van Hout, B., Janssen, M. F., Feng, Y. S., Kohlmann, T., Busschbach, J., Golicki, D., et al. (2012). Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health, 15(5), 708–715. https://doi.org/10.1016/j.jval.2012.02.008.CrossRefPubMed

38.

van Reenen, M., & Oppe, M. (2015). EQ-5D-3L user guide (p. 22). Rotterdam: EuroQol Research Foundation.

39.

Mwanyangala, M., Mayombana, C., Urassa, H., Charles, J., Mahutanga, C., Abdullah, S., et al. (2010). Health status and quality of life among older adults in rural Tanzania. Global in Health Action, 3(1), 2142. https://doi.org/10.3402/gha.v3i0.2142.CrossRef

40.

World Bank Group. (2015). Tanzania mainland poverty assessment. Washington DC: World Bank.

41.

Kinsella, K., Phillips, D., Butz, W. P., Bentzen, M. P., & Hokenson, R. F. (2005). Global aging: The challenge of success population reference bureau. Population Bulletin, 60(1), 1–44.

42.

Narapureddy, B., Naveen, K. H., Madithati, P., Singh, R. S., & Ra, P. (2012). Socio-demographic profile and health care seeking behaviour of rural geriatric population of Allahabad district of UP: A cross sectional study. International Journal of Medical Science and Public Health, 1(2), 87.CrossRef

43.

Fonta, C. L., Nonvignon, J., Aikins, M., Nwosu, E., & Aryeetey, G. C. (2017). Predictors of self-reported health among the elderly in Ghana: A cross sectional study. BMC Geriatrics, 17(1), 1–15.CrossRef

44.

Baxter, R., Hastings, N., Law, A., & Glass, E. J. (2008). AU policy framework and plan of action on aging, Vol. 39, Animal Genetics. Nairobi: HelpAge International.

45.

Roy, K., & Chaudhuri, A. (2008). Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: Evidence from India. Social Science and Medicine, 66(9), 1951–1962.PubMedCrossRef

46.

Marmot, M., & Brunner, E. (2005). Cohort profile: The Whitehall II study. International Journal of Epidemiology, 34(2), 251–256.PubMedCrossRef

47.

Lam, J., Yip, T., & Gee, G. (2012). The physical and mental health effects of age of immigration, age, and perceived difference in social status among first generation Asian Americans. Asian American Journal of Psychology, 3(1), 29–43.CrossRef

48.

Miech, R. A., & Hauser, R. M. (2001). Socioeconomic status and health at midlife: A comparison of educational attainment with occupation-based indicators. Journal of Food Science, 60(1), 181–185.

49.

Van Minh, H., Byass, P., Thi Kim Chuc, N., & Wall, S. (2010). Patterns of health status and quality of life among older people in rural Viet Nam. Global in Health Action, 3(1), 2124. https://doi.org/10.3402/gha.v3i0.2124.CrossRef

50.

Debpuur, C., Welaga, P., Wak, G., & Hodgson, A. (2010). Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana. Global in Health Action, 3(1), 2151. https://doi.org/10.3402/gha.v3i0.2151.CrossRef

51.

Tajvar, M., Arab, M., & Montazeri, A. (2008). Determinants of health-related quality of life in elderly in Tehran, Iran. BMC Public Health, 8, 1–8.CrossRef

52.

Adler, N. E., & Newman, K. (2002). Socioeconomic disparities in health: Pathways and policies. Health Affairs, 21(2), 60–76.PubMedCrossRef

53.

Bloom, D. E. (2007). Education, health, and development. Cambridge: American Academy of Arts & Sciences.

54.

Adams, S. J. (2002). Educational attainment and health: Evidence from a sample of older adults. Education Economics, 10(1), 97–109. https://doi.org/10.1080/09645290110110227.CrossRef

55.

Bassuk, S. S., Berkman, L. F., & Amick, B. C., III. (2002). Socioeconomic status and mortality among the elderly: Findings from four US communities. American Journal of Epidemiology, 155(6), 520–533.PubMedCrossRef

56.

Hannum, E., & Buchmann, C. (2005). Global educational expansion and socio-economic development: An assessment of findings from the social sciences. World Development, 33(3), 333–354.CrossRef

57.

Xavier Gómez-Olivé, F., Thorogood, M., Clark, B. D., Kahn, K., & Tollman, S. M. (2010). Assessing health and well-being among older people in rural South Africa. Global in Health Action, 3(1), 2126. https://doi.org/10.3402/gha.v3i0.2126.CrossRef

58.

Sobhonslidsuk, A., Silpakit, C., Kongsakon, R., & Satitpornkul, P. (2006). Factors influencing health-related quality of life in chronic liver disease. World Journal of Gastroenterology, 12(48), 7786–7791.PubMedPubMedCentralCrossRef

59.

Kang, S. H., Ju, Y. J., Yoon, H. J., Lee, S. A., Kim, W., & Park, E. (2018). The relationship between catastrophic health expenditure and health-related quality of life. International Journal for Equity in Health, 17(1), 166.PubMedPubMedCentralCrossRef

60.

Chang, H. T., Hsu, N. W., Chen, H. C., Tsao, H. M., Lo, S. S., & Chou, P. (2018). Associations between body mass index and subjective health outcomes among older adults: Findings from the Yilan study, Taiwan. International Journal of Environmental Research and Public Health., 15(12), 2645.PubMedCentralCrossRef

61.

Dong, W., Li, Y., Wang, Z., Jiang, Y., Mao, F., Qi, L., et al. (2016). Self-rated health and health-related quality of life among Chinese residents, China, 2010. Health and Quality of Life Outcomes., 14(1), 5.PubMedPubMedCentralCrossRef

62.

Deluga, A., Kosicka, B., Dobrowolska, B., Chrzan-Rodak, A., Jurek, K., Wrońska, I., et al. (2018). Lifestyle of the elderly living in rural and urban areas measured by the FANTASTIC Life Inventory. The Annals of Agricultural and Environmental Medicine, 25(3), 562–567.PubMedCrossRef

63.

Razzaque, A., Nahar, L., Khanam, M. A., & Streatfield, P. K. (2010). Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level. Global in Health Action, 3(1), 70–77. https://doi.org/10.3402/gha.v3i0.4618.CrossRef

64.

Ng, N., Kowal, P., Kahn, K., Naidoo, N., Abdullah, S., Bawah, A., et al. (2010). Health inequalities among older men and women in Africa and Asia: Evidence from eight Health and Demographic Surveillance System sites in the INDEPTH WHO-SAGE Study. Global in Health Action, 3(1), 5420. https://doi.org/10.3402/gha.v3i0.5420.CrossRef

65.

Pfarr, C., Schminan, A., & Schneider, U. (2012). Reporting heterogeneity in self-assessed health among elderly Europeans. Health Economics Review, 2(1), 1–14.CrossRef

Titel: Can survey data facilitate local priority setting? Experience from the Igunga and Nzega districts in Tanzania
verfasst von: Malale Tungu
Gasto Frumence
Mughwira Mwangu
Anna-Karin Hurtig
Lars Lindholm
Publikationsdatum: 13.06.2020
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 11/2020
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-020-02547-w

Springer Medizin

Abstract

Purpose

Methodology

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2020

Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer

Differences in physical and psychological health in patients with chronic low back pain: a national survey in general Spanish population

Patterns of racial/ethnic disparities in baseline health-related quality of life and relationship with overall survival in patients with colorectal cancer

Correction to: Trends and predictors of multidimensional health-related quality of life after living donor kidney transplantation

Exploring health-related quality of life and frailty in older adults based on the Korean Frailty and Aging Cohort Study

Life satisfaction in persons with mental disorders