Does reporting behaviour bias the measurement of social inequalities in self-rated health in Indonesia? An anchoring vignette analysis

PURPOSE: Studies on self-rated health outcomes are fraught with problems when individuals’ reporting behaviour is systematically biased by demographic, socio-economic, or cultural factors. Analysing the data drawn from the Indonesia Family Life Survey 2007, this paper aims to investigate the extent of differential health reporting behaviour by demographic and socio-economic status among Indonesians aged 40 and older ([Formula: see text] ). METHODS: Interpersonal heterogeneity in reporting style is identified by asking respondents to rate a number of vignettes that describe varying levels of health status in targeted health domains (mobility, pain, cognition, sleep, depression, and breathing) using the same ordinal response scale that is applied to the self-report health question. A compound hierarchical ordered probit model is fitted to obtain health differences by demographic and socio-economic status. The obtained regression coefficients are then compared to the standard ordered probit model. RESULTS: We find that Indonesians with more education tend to rate a given health status in each domain more negatively than their less-educated counterparts. Allowing for such differential reporting behaviour results in relatively stronger positive education effects. CONCLUSION: There is a need to correct for differential reporting behaviour using vignettes when analysing self-rated health measures in older adults in Indonesia. Unless such an adjustment is made, the salutary effect of education will be underestimated

Geography and social distribution of malaria in Indonesian Papua: A cross-sectional study

BACKGROUND: Despite being one of the world’s most affected regions, only little is known about the social and spatial distributions of malaria in Indonesian Papua. Existing studies tend to be descriptive in nature; their inferences are prone to confounding and selection biases. At the same time, there remains limited malaria-cartographic activity in the region. Analysing a subset (N = 22,643) of the National Basic Health Research 2007 dataset (N = 987,205), this paper aims to quantify the district-specific risk of malaria in Papua and to understand how socio-demographic/economic factors measured at individual and district levels are associated with individual’s probability of contracting the disease. METHODS: We adopt a Bayesian hierarchical logistic regression model that accommodates not only the nesting of individuals within the island’s 27 administrative units but also the spatial autocorrelation among these locations. Both individual and contextual characteristics are included as predictors in the model; a normal conditional autoregressive prior and an exchangeable one are assigned to the random effects. Robustness is then assessed through sensitivity analyses using alternative hyperpriors. RESULTS: We find that rural Papuans as well as those who live in poor, densely forested, lowland districts are at a higher risk of infection than their counterparts. We also find age and gender differentials in malaria prevalence, if only to a small degree. Nine districts are estimated to have higher-than-expected malaria risks; the extent of spatial variation on the island remains notable even after accounting for socio-demographic/economic risk factors. CONCLUSIONS: Although we show that malaria is geography-dependent in Indonesian Papua, it is also a disease of poverty. This means that malaria eradication requires not only biological (proximal) interventions but also social (distal) ones

Multidimensional poverty in Indonesia:Trend over the last decade (2003-2013)

The notion of poverty as an experience of multiple deprivation has been widely acknowledged. In Indonesia, however, poverty assessment has almost exclusively been conducted within the monetary space; even when multidimensionality is admitted, it has always been computed using variants of marginal method that are indifferent to joint deprivation. Applying a novel measurement method that is sensitive to both the incidence and the intensity of multiple deprivation to data from the National Socio-economic Survey (Susenas), this paper investigates the extent and the patterns of multidimensional poverty in Indonesia from 2003 to 2013 ([Formula: see text] ). An Indonesian version of the multidimensional poverty index is constructed by augmenting the existing consumption poverty measure with information on health and education. Results suggest that there was an unambiguous poverty reduction over the last decade at both national and sub-national levels. The data also reveal that progress has been inclusive across population subgroups, although spatial variation remains notable. The new poverty measurement method proves to be easily adaptable to the Indonesian context and could complement the methods currently employed by the Indonesian Statistical Bureau