Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs

Whitney M Moret

doi:10.9745/GHSP-D-17-00291

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TABLE 1.

Simple Economic Strengthening Tool Developed for Cross-Project Comparisons in Uganda

1.	What is the MAIN source of household income?
Options	a) None	b) Remittances, pension, gratuity, donations	c) Casual laborer	d) Informal job/employment	e) Peasantry farming/hiring out labour on other farms/garden	f) Petty business	g) Formal business	h) Commercial farming	i) Formal job/ employment
Score	3	2	2	2	2	0	0	0	0
2.	What is the current monthly HH income? (express amount in Uganda Shillings, then score according to range)
__________________________ Uganda Shillings
Options	a) Less than 50,000		b) 50,000 – 100,000		c) 100,000 –150,000	d) 150,000 – 200,000		e) Above 200,000
Score	3		2		2	2		0
3.	How much money does the household have in savings?
__________________________ Uganda Shillings
Options	a) Less than 30,000		b) 30,000 – 60,000		c) 60,000 –90,000	d) 90,000 –120,000		e) Above 120,000
Score	3		2		2	1		0
4.	In how many of the last three months have you consistently been able to pay for the following items without having to sell HH productive assets like land, bicycle or borrowing at very high rates of interest (more than 30%)?
						Number of months (0–3)
	1) Food, shelter, and water
	2) Health care
	3) Education
	Add total months (1 + 2+3)→
Options	a) Total=9		b) Total=8		c) Total=7	d) Total=4–6		e) Total=0–3
Score	0		0		1	2		3
5.	If you had an unexpected shock, like a death in the family, happen tomorrow, how would you handle the expenses? (tick all that apply)
Options	(Do not read the options below; wait for the response and then tick those that correspond.)					Tick all that apply		Circle highest score
	1) Pay with cash on hand/savings							0
	2) Seek contributions/gifts from friends, relatives, community members, church help, etc.							3
	3) Request help from a charitable organization, CBO, NGO							3
	4) Borrow from a friend or relative or savings group and pay back later							1
	5) Look for another source of income near my home							1
	6) Reduce household spending a little							1
	7) Reduce household spending a lot							2
	8) Sell small livestock, household goods or items used in the household							2
	9) Migrate for work							2
	10) Borrow from money lender at high interest							3
	11) Sell bicycle, land, tools or other items that help produce income							3
	12) Break up the household—send children to others to care for							3
	13) Go without food							3
	14) Engage in transactional sex or illegal activities							3
6.	Over the past [12 months (baseline)/6 months (subsequent)], what has been the MAIN source of food consumed by your HH?
Options	a) Donated		b) Given in return for work only		c) Bought from the market			d) Home grown
Score	3		3		2			0
7.	How many meals does the HH have in a day?
Options	a) Some days, no meal		b) One meal		c) 2 meals per day			d) 3 or more meals per day
Score	3		3		1			0
8.	Do the following apply to this HH? Indicate (Yes/No) (observe for yourself where applicable)						Yes	No	N/A
	1) Does the HH have access to safe water within 30 minutes (half an hour) or harvest rain water for domestic use?
	2) Does the HH have a clean compound?
	3) Does the HH have access to a public health facility within 5 kilometers?
	4) Does the HH have a drying rack for HH utensils?
	5) Does the HH have a garbage pit or dust bin?
	6) Does the HH have a separate house for animals?
	7) Does the HH have clean water and soap for hand washing?
	8) Do all HH members sleep under a mosquito net?
Options	a) If 4 or more are No		b) If 3 are No		c) If 2 are No	d) If 1 is No	e) If all are Yes or N/A
Score	3		3		2	1	0
9.	Does the household have a stable shelter that is adequate, safe, and dry? (observe yourself)
Options	a) No stable shelter, adequate or safe place to live		b) Shelter is not adequate, needs major repairs		c) Shelter needs somerepairs but is fairly adequate, safe, and dry		d) Shelter is safe,adequate, and dry
Score	3		2		2		0

Abbreviations: CBO, community-based organization; HH, household.

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TABLE 2.

Summary of ASPIRES Assessments of Economic Vulnerability Tools

Tool	Definition of Economic Vulnerability	Domains Assessed	Validation Measures	Findings
Côte d'Ivoire Vulnerability Assessment	The degree of inability of households to provide for the health, education, and nutritional needs of household members to mitigate the economic and health impact of HIV, cope with infection, and reduce their risk for acquiring HIV (for those without HIV).	Financial capital Physical capital Natural capital Social capital Human capital	Poverty likelihood Côte d'Ivoire Progress out of Poverty Index (PPI)	The 4 components created using principal component analysis explained only 21% of the variance among items Component 1 was moderately correlated (r=.69) with the rCSI, FCS (r=.55), and PPI (r=.46) The 65 vulnerability measures examined did not cluster in ways that would allow for the creation of a small number of composite measures to develop a scale
Côte d'Ivoire Vulnerability Assessment			Food Security: Reduced Coping Strategies Index (rCSI) Food Consumption Score (FCS)
Uganda Simple Economic Strengthening Tool	PEPFAR classifications of: Destitute Struggling to make ends meet Prepared to grow Not vulnerable	Ability to pay for basic needs Consistency/volatility of income Availability of liquid assets and savings Food security Availability of assets to respond to shocks	Poverty likelihood Uganda Progress out of Poverty Index (PPI)	Moderate, positive correlation with poverty likelihood (r=.43)
South Africa Household Tool	PEPFAR classifications of: Destitute Struggling to make ends meet Prepared to grow Not vulnerable	Ability to pay for basic needs Consistency/volatility of income Availability of liquid assets and savings Food security Availability of assets to respond to shocks	Poverty likelihood South Africa Progress out of Poverty Index (PPI)	No significant association between poverty likelihood and tool classification (P=.25) No significant association between classifications generated during community ranking exercise and tool classification (P=.77) Modest association between self-classification and tool classification (weighted kappa=.32) Significant but non-linear association between data collector classification and tool classification (P=.003)
South Africa Household Tool			Local classifications Community rankings Self-classification Data collector classification
South Africa Girl Tool	The prevalence of economic factors that lead to transactional sex, and therefore increase risk for HIV.	Perception of needs met Pressure to contribute to the household Availability of cash Food security Shocks Safety nets Financial goals Control over assets Control over economic decision making Personal documentation Gender attitudes	Adolescent girls' HIV vulnerability Vulnerable Girls Index (VGI)	No statistically significant correlations between the Girl Tool and the VGI (P=.25)

Abbreviations: ASPIRES, Accelerating Strategies for Practical Innovation and Research in Economic Strengthening; PEPFAR, U.S. President's Plan for Emergency AIDS Relief.