Chronic diseases, healthcare use and disability in Malawi:

Our proposed data collection, empirical analyses and policy intervention build on and complement an established longitudinal data collection effort: The Malawi Longitudinal Study of Families and Health (MLSFH). The MLSFH is one of very few long-standing, publicly available longitudinal cohort studies in a sub-Saharan African (SSA) context. It provides a rare record of more than a decade of demographic, socioeconomic and health conditions. Since 1998 it has regularly collected information on socioeconomic and demographic characteristics, health, sexual behaviors, risk perceptions and subjective expectations, social networks and social capital, intergenerational relations and family/household dynamics in seven survey rounds of up to 4,000 individuals.

The proposed data collection activities as part of this project build on the 2013 round of the MLSFH, which comprised a sample of 1,500 mature adults aged 45 and older. This baseline survey collected comprehensive information on health and wellbeing (including physical health, HIV/AIDS, cognitive function, mental health and anxiety, and biomarkers and functional performance tests), health behaviors, healthcare use, subjective expectations, and measures of work productivity as well as disability.

To study the impact of chronic disease for the evolution of health, healthcare use, work productivity, poverty and human capital investments, the requested funding will support the collection of six additional rounds of data following the 2013 baseline sample of 1,500 mature adults over time. Given the focus of the overall research project, the proposed data collection effort will couple the continuation of key longitudinal items with new survey modules specifically targeted toward the study of chronic disease and its consequences in terms of healthcare use and expenditures, treatment and—importantly—socioeconomic outcomes such as work disability, earnings, poverty and human capital investments. Specifically, the envisaged data collection will contain new or more detailed information on healthcare use and expenditures, medication use (medication inventory), health literacy and health expectations, visual assessments, blood pressure measurements, mental health and anxiety, chronic pain, time-use based measures of productivity and wellbeing.