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Comparing estimates of household expenditures between pictorial diaries and surveys in three low- and middle-income countries

Author

Listed:
  • Adrianna Murphy
  • Benjamin Palafox
  • Jephat Chifamba
  • Iolanthé M Kruger
  • Brian J Ncube
  • Tatenda L Ncube
  • Sumathy Rangarajan
  • Elizabeth Catherina Swart
  • Lungiswa Tsolkile
  • Marjan Walli-Attaei
  • Nicola J West
  • Karen E Yeates
  • Salim Yusuf
  • Martin McKee
  • Kara Hanson

Abstract

In most low- and middle-income countries (LMICs), household out-of-pocket (OOP) health spending constitutes a major source of healthcare financing. Household surveys are commonly used to monitor OOP health spending, but are prone to recall bias and unable to capture seasonal variation, and may underestimate expenditure–particularly among households with long-term chronic health conditions. Household expenditure diaries have been developed as an alternative to overcome the limitations of surveys, and pictorial diaries have been proposed where literacy levels may render traditional diary approaches inappropriate. This study compares estimates for general household and chronic healthcare expenditure in South Africa, Tanzania and Zimbabwe derived using survey and pictorial diary approaches. We selected a random sub-sample of 900 households across urban and rural communities participating in the Prospective Urban and Rural Epidemiology study. For a range of general and health-specific categories, OOP expenditure estimates use cross-sectional survey data collected via standardised questionnaire, and data from these same households collected via two-week pictorial diaries repeated four times over 2016–2019. In all countries, average monthly per capita expenditure on food, non-food/non-health items, health, and consequently, total household expenditure reported by pictorial diaries was consistently higher than that reported by surveys (each p

Suggested Citation

  • Adrianna Murphy & Benjamin Palafox & Jephat Chifamba & Iolanthé M Kruger & Brian J Ncube & Tatenda L Ncube & Sumathy Rangarajan & Elizabeth Catherina Swart & Lungiswa Tsolkile & Marjan Walli-Attaei & , 2023. "Comparing estimates of household expenditures between pictorial diaries and surveys in three low- and middle-income countries," PLOS Global Public Health, Public Library of Science, vol. 3(4), pages 1-14, April.
  • Handle: RePEc:plo:pgph00:0001739
    DOI: 10.1371/journal.pgph.0001739
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    References listed on IDEAS

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    6. Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
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