Why Traditional Surveys Miss the Real Story
Standard household surveys often ask:
- “How much did you spend on health in the last month/3 months/12 months?”
But real life is messy:
- People forget small but frequent expenses
- Lump-sum costs (e.g., hospitalization) distort recall
- Informal payments and borrowing are underreported
That’s where health financial diaries come in.
What Are Health Financial Diaries?
Health financial diaries:
- Track daily or weekly health-related financial flows, such as:
- Clinic fees
- Drugs and diagnostics
- Transport to facilities
- Lost income due to illness
- Borrowing, gifts, and asset sales to pay for care
- Used over weeks or months to:
- Capture volatility
- Understand coping strategies
- Reveal hidden burdens of illness
What They Let You Analyze
With diaries, you can:
- Map cash flow shocks due to health events
- Estimate catastrophic health expenditure more accurately
- Understand borrowing patterns and informal insurance
- Link episodes of illness to:
- Treatment choices
- Facility types
- Delays and drop-outs
Challenges (And How to Design Around Them)
- Participant fatigue:
- Keep instruments short and focused
- Use prompts (SMS, phone, in-person visits)
- Data quality:
- Train enumerators well
- Use high-frequency checks to catch inconsistencies
- Ethics and burden:
- Compensate fairly
- Respect privacy and sensitivity around finances
Portfolio Idea: A Mini Financial Diaries Simulation
Even without field data, you can:
- Simulate 50–100 households with:
- Daily income
- Random health shocks
- Different coping strategies
- Use R to:
- Plot daily cash flows
- Identify “catastrophic” events
- Compare “with insurance” vs “without insurance” scenarios
Publish:
- A small dashboard or Quarto report with:
- Key charts
- A short interpretation section
This shows you understand health financing at the household level, not just at the macro budget level.