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ORIGINAL ARTICLE
Open Access

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

Whitney M Moret
Global Health: Science and Practice March 2018, 6(1):150-160; https://doi.org/10.9745/GHSP-D-17-00291
Whitney M Moret
aFHI 360, Washington, DC, USA.
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  • For correspondence: wmoret@fhi360.org
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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?
    Optionsa) Noneb) Remittances, pension, gratuity, donationsc) Casual laborerd) Informal job/employmente) Peasantry farming/hiring out labour on other farms/gardenf) Petty businessg) Formal businessh) Commercial farmingi) Formal job/ employment
    Score322220000
    2.What is the current monthly HH income? (express amount in Uganda Shillings, then score according to range)
    __________________________ Uganda Shillings
    Optionsa) Less than 50,000b) 50,000 – 100,000c) 100,000 –150,000d) 150,000 – 200,000e) Above 200,000
    Score32220
    3.How much money does the household have in savings?
    __________________________ Uganda Shillings
    Optionsa) Less than 30,000b) 30,000 – 60,000c) 60,000 –90,000d) 90,000 –120,000e) Above 120,000
    Score32210
    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)→
    Optionsa) Total=9b) Total=8c) Total=7d) Total=4–6e) Total=0–3
    Score00123
    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 applyCircle highest score
    1) Pay with cash on hand/savings0
    2) Seek contributions/gifts from friends, relatives, community members, church help, etc.3
    3) Request help from a charitable organization, CBO, NGO3
    4) Borrow from a friend or relative or savings group and pay back later1
    5) Look for another source of income near my home1
    6) Reduce household spending a little1
    7) Reduce household spending a lot2
    8) Sell small livestock, household goods or items used in the household2
    9) Migrate for work2
    10) Borrow from money lender at high interest3
    11) Sell bicycle, land, tools or other items that help produce income3
    12) Break up the household—send children to others to care for3
    13) Go without food3
    14) Engage in transactional sex or illegal activities3
    6.Over the past [12 months (baseline)/6 months (subsequent)], what has been the MAIN source of food consumed by your HH?
    Optionsa) Donatedb) Given in return for work onlyc) Bought from the marketd) Home grown
    Score3320
    7.How many meals does the HH have in a day?
    Optionsa) Some days, no mealb) One mealc) 2 meals per dayd) 3 or more meals per day
    Score3310
    8.Do the following apply to this HH? Indicate (Yes/No) (observe for yourself where applicable)YesNoN/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?
    Optionsa) If 4 or more are Nob) If 3 are Noc) If 2 are Nod) If 1 is Noe) If all are Yes or N/A
    Score33210
    9.Does the household have a stable shelter that is adequate, safe, and dry? (observe yourself)
    Optionsa) No stable shelter, adequate or safe place to liveb) Shelter is not adequate, needs major repairsc) Shelter needs somerepairs but is fairly adequate, safe, and dryd) Shelter is safe,adequate, and dry
    Score3220
    • Abbreviations: CBO, community-based organization; HH, household.

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    TABLE 2.

    Summary of ASPIRES Assessments of Economic Vulnerability Tools

    ToolDefinition of Economic VulnerabilityDomains AssessedValidation MeasuresFindings
    Côte d'Ivoire Vulnerability AssessmentThe 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

    Food Security:
    • Reduced Coping Strategies Index (rCSI)

    • Food Consumption Score (FCS)

    Uganda Simple Economic Strengthening ToolPEPFAR 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 ToolPEPFAR 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)

    Local classifications
    • Community rankings

    • Self-classification

    • Data collector classification

    South Africa Girl ToolThe 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.

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Global Health: Science and Practice: 6 (1)
Global Health: Science and Practice
Vol. 6, No. 1
March 21, 2018
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Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs
Whitney M Moret
Global Health: Science and Practice Mar 2018, 6 (1) 150-160; DOI: 10.9745/GHSP-D-17-00291

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Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs
Whitney M Moret
Global Health: Science and Practice Mar 2018, 6 (1) 150-160; DOI: 10.9745/GHSP-D-17-00291
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    • Abstract
    • INTRODUCTION
    • BACKGROUND ON VULNERABILITY ASSESSMENT
    • THREE COUNTRY CASES: METHODS AND FINDINGS
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