The Influence of Income and Livelihood Diversification on Health-Related Quality of Life in Rural Ethiopia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sites
2.2. Data Collection, Sampling, and Participants
2.3. Outcome Variables
2.4. Other Study Variables
- Demographic characteristics included age, gender of household head (male: 1/female: 0), marital status (single/married), education (no schooling, primary, and secondary), ethnicity, household size (number of individuals in household), land size (land size operated by household), and monthly income.
- Livelihood diversification: We applied the normalized Herfindahl–Simpson diversification index to estimate the livelihood diversification index [31]. In order to do so, we first classified livelihood activities by means of on-farm livelihood activities encompassing crop and livestock production, off-farm activities (wages for labor from other farms), nonfarm activities (earning apart from agricultural sources), and self-employment. To estimate livelihood structures at the household level, we also collected information on the income derived from each livelihood activity in the last year. We then calculated the total income share of livelihood activity carried out by the household in a year as follows:Secondly, the Herfindahl–Simpson diversity index was adopted to estimate the level of livelihood diversification index, and the indices were then calculated using the following formula:
- Livestock ownership: The livestock population was calculated using tropical livestock unit (TLU) scores [39]. The TLU conversion factors developed by the Food and Agriculture Organization (FAO) allow for the combination of multiple types of livestock into a weighted measure representing total body weight and market value. A single animal weighing 250 kg represents a single TLU, given weighting factors of 0.7 for cattle, 0.1 for sheep/goats, 0.2 for swine, and 0.01 for chicken.
2.5. Data Analysis
3. Results
3.1. Descriptive Summary and Internal Consistency Reliability
3.2. Health Status by Participants’ General Characteristics
3.3. Factors Associated with General Physical and Mental Health
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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SF-8 Item | Reliability | Spearman’s Correlation Coefficient | |||
---|---|---|---|---|---|
Mean (SD) | Cronbach’s α Coefficient | Item–Total Correlation | PCS | MCS | |
General health | 41.03 (13.89) | 0.949 | 0.775 | 0.877 | 0.535 |
Physical functioning | 26.11 (12.74) | 0.940 | 0.861 | 0.862 | 0.527 |
Role physical | 28.47 (10.16) | 0.940 | 0.863 | 0.837 | 0.578 |
Bodily pain | 32.24 (12.86) | 0.938 | 0.885 | 0.876 | 0.570 |
Vitality | 38.87 (9.02) | 0.944 | 0.799 | 0.807 | 0.703 |
Social functioning | 29.85 (6.83) | 0.947 | 0.810 | 0.733 | 0.706 |
Role emotional | 34.20 (9.25) | 0.942 | 0.833 | 0.679 | 0.830 |
Mental health | 27.10 (10.64) | 0.941 | 0.846 | 0.709 | 0.787 |
Overall PCS score | 30.50 (12.18) | ||||
Overall MCS score | 34.40 (7.26) |
Variables | All | N (%) | PCS Mean ± SD | p Value | MCS Mean ± SD | p Value |
---|---|---|---|---|---|---|
Gender | Male | 218 (80.70) | 29.28 ± 11.42 | <0.001 | 33.62 ± 6.67 | <0.001 |
Female | 52 (19.30) | 35.90 ± 14.00 | 38.09 ± 8.69 | |||
Age | ≤30 | 16 (5.90) | 26.79 ± 10.34 | 0.068 | 33.84 ± 6.60 | 0.038 |
31–40 | 69 (25.60) | 29.09 ± 11.29 | 32.50 ± 5.90 | |||
41–50 | 81 (30.00) | 29.90 ± 12.57 | 34.31 ± 7.23 | |||
51–60 | 53 (19.60) | 32.25 ± 11.74 | 35.10 ± 7.14 | |||
61–70 | 35 (13.00) | 35.30 ± 12.98 | 36.87 ± 8.60 | |||
>70 | 16 (5.90) | 31.99 ± 13.70 | 37.29 ± 9.52 | |||
Marital status | Single | 56 (20.70) | 36.10 ± 14.10 | <0.001 | 37.57 ± 8.45 | <0.001 |
Married | 214 (79.30) | 29.10 ± 11.27 | 33.68 ± 6.77 | |||
Education | No schooling | 211 (78.10) | 31.43 ± 12.73 | 0.130 | 34.92 ± 7.64 | 0.431 |
≤Primary | 41 (15.20) | 26.09 ± 9.44 | 33.09 ± 5.66 | |||
≥Secondary | 18 (6.70) | 30.48 ± 9.60 | 32.49 ± 5.98 | |||
Ethnicity | Amhara | 205 (75.90) | 30.02 ± 12.36 | 0.364 | 34.16 ± 6.72 | 0.202 |
Agew | 57 (21.10) | 32.60 ± 11.58 | 36.18 ± 9.28 | |||
Others | 8 (3.00) | 29.66 ± 12.90 | 30.61 ± 1.13 | |||
Household size | ≤5 | 130 (48.10) | 32.25 ± 13.15 | 0.027 | 35.24 ± 7.79 | 0.103 |
>5 | 140 (51.90) | 28.97 ± 11.09 | 33.78 ± 6.77 | |||
Land owned | <1 ha | 123 (45.60) | 31.10 ± 12.74 | 0.505 | 35.04 ± 7.65 | 0.255 |
≥1 ha | 147 (54.40) | 30.10 ± 11.79 | 34.02 ± 6.99 | |||
Watersheds | Guder | 90 (33.30) | 30.04 ± 11.21 | 0.884 | 34.28 ± 7.04 | 0.886 |
Aba Gerima | 90 (33.30) | 30.91 ± 13.93 | 34.38 ± 7.51 | |||
Dibatie | 90 (33.30) | 30.71 ± 11.44 | 34.79 ± 7.42 | |||
Income (Birr/month) | <300 (Q1) | 68 (25.20) | 30.00 ± 12.38 | 0.012 | 35.64 ± 8.51 | 0.053 |
301–650 (Q2) | 67 (24.80) | 27.57 ± 10.98 | 32.91 ± 6.44 | |||
651–1000(Q3) | 68 (25.20) | 30.24 ± 12.18 | 33.87 ± 6.75 | |||
>1000 (Q4) | 67 (24.80) | 34.42 ± 12.52 | 35.51± 7.13 | |||
Livelihood diversification * | ≤0.01 (Q1) | 104 (38.50) | 29.11 ± 12.32 | 0.022 | 34.51 ± 7.33 | 0.287 |
0.02–0.24 (Q2) | 32 (11.90) | 28.22 ± 11.06 | 33.09 ± 6.69 | |||
0.25–0.50 (Q3) | 68 (25.20) | 29.97 ± 10.76 | 33.65 ± 6.30 | |||
≥0.51 (Q4) | 64 (23.70) | 34.53 ± 13.20 | 35.86 ± 8.26 | |||
Tropical livestock unit | ≤2.30 (Q1) | 70 (25.90) | 35.33 ± 14.39 | 0.045 | 36.91 ± 8.76 | 0.025 |
2.31–3.85 (Q2) | 68 (25.20) | 29.43 ± 11.83 | 34.64 ± 7.51 | |||
3.86-5.45 (Q3) | 68 (25.20) | 28.94 ± 10.25 | 32.52 ± 5.49 | |||
≥5.46 (Q4) | 64 (23.70) | 28.23 ± 10.72 | 33.74 ± 6.35 |
PCS | MCS | |||||||
---|---|---|---|---|---|---|---|---|
Variables | β | SE | 95% CI | p | β | SE | 95% CI | p |
Female (male ref) | 2.47 | 2.40 | −2.26; 7.21 | 0.305 | 2.82 | 1.41 | 0.02; 5.61 | 0.048 |
Age ≤ 30 (age > 70 ref) | −4.10 | 4.01 | −12.01; 3.79 | 0.307 | −3.97 | 2.64 | −9.18; 1.23 | 0.134 |
Age 31–40 (age > 70 ref) | −0.96 | 3.38 | −7.62; 5.69 | 0.776 | −4.80 | 2.36 | −9.45; −0.15 | 0.043 |
Age 41–50 (age > 70 ref) | −0.54 | 3.39 | −7.23; 6.14 | 0.872 | −3.20 | 2.45 | −8.03; 1.62 | 0.193 |
Age 51–60 (age > 70 ref) | 1.65 | 3.47 | −5.19; 8.49 | 0.636 | −2.58 | 2.47 | −7.46; 2.29 | 0.298 |
Age 61–70 (age > 70 ref) | 3.62 | 3.60 | −3.48; 10.73 | 0.317 | −0.69 | 2.59 | −5.79; 4.41 | 0.790 |
Married (single ref) | −3.90 | 2.47 | −8.77; 0.95 | 0.115 | −1.52 | 1.28 | −4.04; 1.01 | 0.237 |
Household size | 0.13 | 0.40 | −0.65; 0.92 | 0.733 | 0.03 | 0.25 | −0.47; 0.54 | 0.890 |
Income Q1 (Q4 ref) | −4.45 | 2.10 | −8.60; −0.31 | 0.035 | 0.46 | 1.31 | −2.12; 3.05 | 0.722 |
Income Q2 (Q4 ref) | −5.38 | 2.04 | −9.40; −1.36 | 0.009 | −1.82 | 1.26 | −4.31; 0.65 | 0.148 |
Income Q3 (Q4 ref) | −2.25 | 2.18 | −6.55; 2.04 | 0.302 | −0.70 | 1.26 | −3.19; 1.78 | 0.579 |
Livelihood diversification * | 5.56 | 2.09 | 1.43; 9.68 | 0.008 | − | − | − | − |
Tropical livestock unit | −0.54 | 0.22 | −0.99; −0.09 | 0.017 | −0.17 | 0.13 | −0.43; 0.08 | 0.197 |
Constant | 35.69 | 4.10 | 27.60; 43.78 | <0.001 | 39.18 | 2.60 | 34.06; 44.31 | <0.001 |
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Majbauddin, A.; Otani, S.; Tsunekawa, A.; Haregeweyn, N.; Abeje, M.T.; Nigussie, Z.; Alam, I.; Qing, Q.; Masumoto, T.; Kurozawa, Y. The Influence of Income and Livelihood Diversification on Health-Related Quality of Life in Rural Ethiopia. Int. J. Environ. Res. Public Health 2020, 17, 2709. https://doi.org/10.3390/ijerph17082709
Majbauddin A, Otani S, Tsunekawa A, Haregeweyn N, Abeje MT, Nigussie Z, Alam I, Qing Q, Masumoto T, Kurozawa Y. The Influence of Income and Livelihood Diversification on Health-Related Quality of Life in Rural Ethiopia. International Journal of Environmental Research and Public Health. 2020; 17(8):2709. https://doi.org/10.3390/ijerph17082709
Chicago/Turabian StyleMajbauddin, Abir, Shinji Otani, Atsushi Tsunekawa, Nigussie Haregeweyn, Misganaw Teshager Abeje, Zerihun Nigussie, Intekhab Alam, Qing Qing, Toshio Masumoto, and Youichi Kurozawa. 2020. "The Influence of Income and Livelihood Diversification on Health-Related Quality of Life in Rural Ethiopia" International Journal of Environmental Research and Public Health 17, no. 8: 2709. https://doi.org/10.3390/ijerph17082709
APA StyleMajbauddin, A., Otani, S., Tsunekawa, A., Haregeweyn, N., Abeje, M. T., Nigussie, Z., Alam, I., Qing, Q., Masumoto, T., & Kurozawa, Y. (2020). The Influence of Income and Livelihood Diversification on Health-Related Quality of Life in Rural Ethiopia. International Journal of Environmental Research and Public Health, 17(8), 2709. https://doi.org/10.3390/ijerph17082709