Estimating Socioeconomic Status for Health Equity Surveillance in Cameroon: An Expert Opinion Survey.
10 affiliations
- 1Department of Health Research, Meilleur Accès aux Soins de Santé, Yaounde, CMR.
- 2Department of Public Health, University of Yaounde 1, Yaounde, CMR.
- 3Department of Data Science, Higher Institute for Scientific and Medical Research, Yaounde, CMR.
- 4Department of Chemistry-Biology, University of Bertoua, Bertoua, CMR.
- 5Department of Cardiology, Vrije Universiteit Brussel, Brussels, BEL.
- 6Division of Health Research, Challenges Initiative Solutions, Yaounde, CMR.
- 7Division of Health Research, Challenges Initiative Solutions, Yaoundé, CMR.
- 8Department of Surgery, University of Buea, Buea, CMR.
- 9Department of Surgery, University of California Los Angeles, Los Angeles, USA.
- 10Division of Biostatistics, University of California Berkeley, Berkeley, USA.
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.
Related
- Use of Metagenomic Next-Generation Sequencing to Investigate Respiratory Pathogens in Influenza-Negative Nasopharyngeal Swabs From Cameroon's National Influenza Surveillance.
- Same zone diameter, different verdict: clinical and surveillance implications of EUCAST 2025 versus CLSI 2025 breakpoint discordance among Enterobacterales, Staphylococcus and Pseudomonas isolates at Buea Regional Hospital, Cameroon
- Barriers to the functionality and responsiveness of the malaria surveillance and data use system in Cameroon: a qualitative cross-sectional study
- Socioeconomic status and temporal trends in unmet needs for community-based home visiting services among disabled older adults in China
- Recommendations & Caveats for Recruiting Stratified Samples Across Race/Ethnicity, Gender, and Socioeconomic Status Using the Prolific Online Platform
BibTeX
@article{nkum2026estimating,
title = {{Estimating Socioeconomic Status for Health Equity Surveillance in Cameroon: An Expert Opinion Survey.}},
author = {Collins Buh Nkum and Yannick Niamsi Emalio and Marie Nicole Ngoufack and Gilles Protais Lekelem Dongmo and Brian Bongwong Tamfon and Aude Nanfak and Jerome Sedowo Eyi Kodjo and Alain Chichom-Mefire and Catherine Juillard and Alan Hubbard and Georges Nguefack-Tsague},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116688},
url = {https://europepmc.org/article/MED/42923608},
note = {CC BY},
}
RIS
TY - JOUR
TI - Estimating Socioeconomic Status for Health Equity Surveillance in Cameroon: An Expert Opinion Survey.
AU - Collins Buh Nkum
AU - Yannick Niamsi Emalio
AU - Marie Nicole Ngoufack
AU - Gilles Protais Lekelem Dongmo
AU - Brian Bongwong Tamfon
AU - Aude Nanfak
AU - Jerome Sedowo Eyi Kodjo
AU - Alain Chichom-Mefire
AU - Catherine Juillard
AU - Alan Hubbard
AU - Georges Nguefack-Tsague
PY - 2026
DA - 2026/09/21
JO - Cureus
DO - 10.7759/cureus.116688
UR - https://europepmc.org/article/MED/42923608
AB - 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.
SN - 2168-8184
ER -