Work

Estimating Socioeconomic Status for Health Equity Surveillance in Cameroon: An Expert Opinion Survey

Year: 2026

Type: article

Abstract: BACKGROUND: Despite growing awareness of the association between socioeconomic status (SES) and health outcomes, no widely accepted, rapidly implementable method for estimating SES exists in resource-limited settings. An exception is the Demographic and Health Surveys (DHS) wealth quintile index constructed from household asset ownership. To support health equity surveillance, a method of individual SES estimation that requires fewer household assets is needed. This study aimed to identify the DHS household asset items most relevant for measuring SES in Cameroon. MATERIALS AND METHODS: This cross-sectional study assessed expert opinion on the indicators used to measure SES. Participants were interviewed using a structured questionnaire and included stakeholders involved in designing and implementing DHS in Cameroon for many years. Using a five-point Likert scale, experts rated the relevance of DHS household asset items for measuring SES. The questionnaire was highly reliable (Cronbach's alpha: 0.943, 95% CI: 0.920-0.961, p < 0.001) for the 29 retained items measuring SES. RESULTS: Among the 65 experts with complete responses, the proportion agreeing or strongly agreeing that an asset is a useful measure of SES ranged from 29.2% to 84.6% across the 29 items; a normalized weight (each item's share of the total agreement counts across items, summing to 1) was also derived for each item and ranged from 0.016 to 0.047. The 12 DHS assets with the highest normalized weight included refrigerator (84.6%), television (83.1%), laptop/notebook (80.0%), agricultural land (80.0%), mixer/grinder (78.5%), cable/satellite (78.5%), cell phone (76.9%), modem/Internet key (75.4%), computer tablet (73.8%), gas stove (72.3%), car/truck (72.3%), and water pump (70.8%), with respective normalized weights of 0.047, 0.046, 0.044, 0.044, 0.043, 0.043, 0.042, 0.042, 0.041, 0.040, 0.040, and 0.039. CONCLUSIONS: This research underscores the importance of integrating local expert insights to refine SES measurement and improve health outcomes, particularly in Cameroon. Future research should explore applying this expert-opinion-driven framework in various contexts to create more comprehensive, robust, and reliable SES indicators.

Source: Cureus

DOI: 10.7759/cureus.116688