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Using the Demographic Health Survey wealth index to create family planning market segments based on absolute income levels
  1. Nicole Bellows,
  2. Michelle Weinberger,
  3. Meghan Reidy
  1. Avenir Health, Glastonbury, Connecticut, USA
  1. Correspondence to Dr Nicole Bellows; nbellows{at}avenirhealth.org

Abstract

Family planning market segmentation approaches typically include analysis by wealth, particularly when considering whether individuals can afford out-of-pocket expenses in the private sector. Most commonly, this is done using the Demographic and Health Survey (DHS) wealth index, which uses a relative approach by summing household asset questions and categorising respondents into five groups from poorest to wealthiest within a country. In addition, the use of absolute measures, such as segmenting populations based on whether one lives below or above the International Poverty line, defined by the World Bank as US$1.90 per person per day, may provide further useful insights when designing strategies to ensure access to family planning. While such measures are not readily available in the DHS, a simple approach can be used to combine the wealth index and World Bank poverty lines to generate an absolute measure for an additional perspective when conducting family planning market segmentation. Family planning market size estimates were made for 24 low-income countries using wealth quintiles and World Bank poverty lines. The results show large variations in market size based on what measure is used, particularly for countries with a high density of poverty. Looking at both types of measures and understanding the reasons for the differences in market size estimates between the approaches can help lend a more nuanced understanding of the distribution of wealth and income in a country, leading to improved family planning market segmentation and ultimately to ensure more women have access to a method of their choice.

  • health services research
  • indices of health and disease and standardisation of rates
  • public health
http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Sanni Yaya

  • Contributors NB drafted the manuscript and created the tables and figures. Both MW and MR contributed data analysis and a detailed review and edits on the manuscript draft.

  • Funding This study was funded by United States Agency for International Development (AID-OAA-A-15-00067).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.