One of the most appropriate ways to measure equity in a healthcare programme is to determine how many of your clients fall into each wealth quintile for your country.
A quintile is 20% of the population. If a population has 1,000,000 people in it, you could separate it into five quintiles of 200,000 each.
The wealth index involves giving each person in the population a score which represents how wealthy they are based on the characteristics of their household. With this score, you can create five ‘wealth quintiles’ as follows: put the poorest 20% into quintile one, the second poorest 20% into quintile two, the middle 20% into quintile three, the second wealthiest 20% into quintile four and the wealthiest 20% into quintile five. This has already been done for most developing countries in the Demographic and Health Surveys.
You can then get data on the characteristics of the households of your franchise’s clients using exactly the same questions as in the DHS for your country. With this you can determine the wealth score for your clients. You can use this data to see which quintiles they are in.
i and ii from the diagram have already been done in the Demographic and Health Survey! We just need to do iii, which is what this guide is all about. That may sound like a complex process, but we have done much of the work already in this toolkit. The questionnaires have already been made and the analysis process has been automated in the Analysis tool, which comes pre-loaded with the DHS data for your country. All you have to do is interview a sample of your clients with the questionnaire and enter the data to the tool.