Indicators of quality of life
QoL was described in terms of general wellbeing and happiness influenced by good health, having money, good social relations and emotional wellbeing. The majority of the participants interviewed defined QoL in a manner very similar to the WHO definition of health as “a state of complete physical, mental and social wellbeing and not merely absence of disease or infirmity” [
24].
One 45-year-old woman, receiving basic care, said that “QoL is about being happy, availability of food, shelter, clothes, and not being sick.” A 42-year-old woman remarked, “QoL is about the wellbeing of my children, their health and my health, and having shelter.” A 39-year-old man, receiving basic care said that “It is when one has all they wish to have. If I have enough money to take care of my family and I am able to work, my QoL is good.” Another man (23 years old) stated that “It’s about being healthy and able to work and earn money.”
The majority of the participants highlighted availability of money as the cornerstone of their wellbeing and hence a good QoL, for example “For me to enjoy life I need to have money” (female, 38 years) and “amidst poverty, nothing moves at all…” (female, 31 years). One 31-year-old man said “It’s all about having work to do and money and no worries as to where to get the next meal…as much as it’s important to be healthy physically and emotionally… we need food and other daily needs. It is impossible to be happy and peaceful when you have no money.”
Almost all interviewees mentioned that money and good health were important to their wellbeing and QoL. Male respondents were more candid when discussing money as a source of wellbeing compared with the women, who were a little more reticent about finances. For instance, one 31-year-old woman expressed QoL as “egyeri yo yimiridemu”, translated as “your standing in society”. When asked what exactly she meant by this, she explained that this referred to her financial situation.
Social relationships were also reported by some of the respondents as key to their wellbeing, for example, “Enjoying my life and the people around me and good relationships with them no quarrels.” (male, 41 years ), “It is important to be surrounded by people who love and care for you” (female, 48), and “a good relationship with my husband, my children’s wellbeing and good relationships with all my family members make me happy” (female, 33).
A lack of happiness due to poor social support was reported by one woman (aged 48). She had a 30-year-old son who she had left with the father when the son was still a baby. She had no close relationship with her son. She had also lost most of her siblings and her only living sister, who lived in the same village, did not wish to associate with her. She was nursing her mother (who was terminally ill with cancer and died just before the final interview). She said “nobody likes me; no one is available to help me… I have no joy.”
Emotional stability was a concern among a few of those interviewed. A 31-year-old woman described QoL as “Life with no worries, no stress…” As happiness was mentioned by a majority of the participants, we explored further what was meant by happiness in follow-up interviews. Happiness was seen as an indicator of QoL. The factors mentioned as sources of happiness included good family relations, good personal and family health, financial wellbeing and social outings. These findings were consistent across all ages and both genders.
One married 45-year-old woman explained: “I am happy when my children are healthy, have school fees and we have peace at home.” Another woman said “Good health and knowing that my family is healthy and well makes me happy—and of course when I have money” (27 years). A 23-year-old man said “My children and wife make me very happy and I enjoy their company.” A 50-year-old man in a polygamous marriage explained: “When my family and myself are healthy and we have all that we need I am very happy. When my family is happy, I am happy too.”
Two women interviewed related happiness and joy to their spiritual wellbeing (religion) and support. Both of them were Christians. “One of my happiest moments is when I am at church, praying and in fellowship with my church members,” said one married 45-year-old woman. The other woman (48 years, single) stated “the only time that I am happy is when I am in church praying and worshiping God.” Male respondents enjoyed going for a drink with friends, and watching football and plays. They derived joy and happiness from these activities: “I enjoy partying and taking alcohol with my friends” (male, 41), “I like talking and spending time with my friends” (male, 37) and “I love watching plays and football on TV, they make me happy” (male, 50). The female respondents’ sources of happiness were primarily related to family and social support, whereas male participants pointed to time out and having fun as sources of happiness.
Both men and women mentioned economic wellbeing as a major contributor to their happiness. According to one 29-year-old man, “… money is everything. If I had enough money, my life would be good.” A 37-year-old woman said “I am very happy when I am able to meet the financial needs of my children.” Finances were also mentioned as a source of unhappiness. “I do not think there is anything good about my life at the moment because my financial situation is so bad,” said one 31-year-old man who had lost his job. Similarly, a 31-year-old woman said “I feel terrible when I have no money; I am not a happy person because my finances are really bad. When we have little food, I have to give it up for my 3-year-old son and I stay without food. Sometimes I take a cup of black tea for my dinner.”