Development of the Demographic Dividend Effort Index, a novel tool to measure existing efforts to create a favourable environment to harness a demographic dividend: Results from an experts' survey from six sub-Saharan African countries

Jean Christophe Rusatira, Carolina Cardona, Michelle Martinez-Baack, Jose G. Rimon, Saifuddin Ahmed

Research output: Contribution to journalArticlepeer-review

Abstract

Objective This study aimed to develop a tool to measure the extent of national efforts in policies, services, research and programmes implemented to cultivate and harness the benefits of a potential demographic dividend in six sub-Saharan African countries. Design The survey was self-administered online using the SurveyMonkey platform. The survey questionnaire covered six key sectors: family planning, maternal and child health, education, women's empowerment, labour market, and governance and economic institution. Each sector-specific questionnaire was structured around five practice domains: policymaking, services and programmes, advocacy, research and civil society. Each item was scored from 1 to 10. Factor analysis was used to select the items to be retained for final score estimation. Simple averages were computed to estimate sectoral and domain scores and overall country scores were estimated using weighted country mean scores. Internal consistency, construct validity and reliability were examined using factor analysis and Cronbach's alpha. Setting Sub-Saharan Africa. Participants A total of 440 knowledgeable informants from six countries; namely, Ethiopia (73), Kenya (69), Nigeria (67), Rwanda (54), Senegal (81) and Tanzania (96). Results Based on the results from factor analysis, 38 items were dropped from the analysis and Cronbach's alpha results ranged from 0.84 to 0.98 across domains. The overall demographic dividend effort index (DDEI) scores ranged between 5.4 (95% CI 5.1 to 5.8) in Ethiopia to 7.7 (95% CI 7.5 to 8.0) in Rwanda. In most countries, the disaggregated scores by sector revealed low scores in the labour market and women's empowerment. Conclusion The DDEI scores highlight important gaps in key health and development sectors. The DDEI proved to be a reliable and internally consistent tool for effort measurement in key demographic dividend sectors. The DDEI can serve as a self-evaluation tool for local actors and may complement existing quantitative tools such as the Global Gender Gap and the Human Capital Index.

Original languageEnglish (US)
Article numbere059937
JournalBMJ open
Volume13
Issue number3
DOIs
StatePublished - Mar 23 2023

Keywords

  • demography
  • health economics
  • international health services
  • public health
  • statistics & research methods

ASJC Scopus subject areas

  • General Medicine

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