Self-reported and independently assessed measures of population health compared: results from the Accra women’s health survey

Allan G. Hill, Harvard University
John K. Anarfi, University of Ghana
Rudolph Darko, Ghana Medical School
Rosemary B. Duda, Harvard Medical School

To improve the assessment of the burden of disease in low-income countries, attempts have been made to capture current morbidity using self-reported measures of health. Few studies have been able to add medical examinations, performance testing or laboratory data to these household surveys. In 2003, the authors directed the Accra Women’s Health Study which included all these elements. The self-reported health measures included international validated questions in surveys such as the SF36, the DHS surveys and the World Health Survey. Comparing the prevalence of conditions in the home interview and the medical examination, we find surprising consistencies – the reports on diabetes in the home interviews matched very well the cases found in the clinic. There are also some major discrepancies – including the reporting of obesity, hypertension and mental illness. These patterns are examined by age and social class in order to identify morbidities that can and cannot be ascertained using self-reported morbidity alone.