SAGE-Goals

SAGE

Study on global AGEing and adult health (WHO-SAGE) – INDIA

SAGE

About SAGE Goals SAGE Instrument Sponsor & Collaborators  Wave-1  Wave-2  Wave-3  Data

Goals of SAGE

The goals of SAGE are to (a) promote a better understanding of the effects of ageing on wellbeing; (b) examine the health status of individuals aged 50- plus as well as changes, trends and patterns that occur over time; and (c) improve the capacity of researchers to analyse the effects of social, economic, health care and policy changes on current and future health. SAGE will provide baseline and longitudinal health-related data on older persons in middle and low income countries. It especially will improve the empirical evidence base on the health and wellbeing of older adults in developing countries, by providing reliable, valid and cross-nationally comparable data, examining health difference across individuals, countries and regions, and providing validated health measurement methods.
The data collection domains in SAGE include self-reported assessments of health, using anchoring vignettes for improved comparability across individuals, communities and populations; assessment of perceptions of wellbeing and quality of life; self-reported assessment of functioning, with measured performance tests on a range of different health domains; biomarkers; and the introduction of a longitudinal study design to allow dynamic examination of changes in health expectations and experiences over the life course and investigation of compression of morbidity in aging populations.


Primary objectives

•    To obtain reliable, valid and comparable data on levels of health in a range of key domains for adult populations who are 50 years and older in nationally representative samples;
•    To examine patterns and dynamics of age-related changes in health and wellbeing, using longitudinal follow-up of survey respondents as they age, and to investigate socioeconomic consequences of these health changes;
•    To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains;
•    To collect data on health examinations and biomarkers to improve reliability of data on morbidity and risk factors and monitor the effect of interventions.

Additional objectives

•    To generate a large enough cohort of older adult populations, and a comparison cohort of younger populations, to permit follow-up of intermediate outcomes, monitoring of trends, examination of transitions and life events, and addressing relationships between determinants and health, wellbeing and health-related outcomes;
•    To develop a mechanism to link survey data to surveillance data from demographic surveillance sites;
•    To build linkages with other national and cross-national ageing studies;
•    To improve methodologies that enhance the reliability and validity of outcomes and determinants;
•    To examine how the mix and distribution of health, health care, socioeconomic and family resources affect key outcomes, including mortality, morbidity and health care utilisation;
•    To provide a public-access information base to engage all stakeholders, including national policy makers and health systems planners, in planning and decision making processes about the health and wellbeing of older adults.

Geographic Coverage and Scope


Why China, Ghana, India, Mexico, Russian Federation and South Africa for WHO-SAGE?


•    To cover a broad range of Low & Middle Income Countries (LMICS)
•    Representative of four world regions based on UN classification
      1.    Africa (Ghana, South Africa)
      2.    Asia (China, India)
      3.    Europe (Russian Federation)
      4.    Latin America (Mexico)
      5.    Countries with large populations ageing at different rates
•    Countries at different stages of the demographic and epidemiological transition
In India SAGE Wave 1, 2 and 3 was implemented in the states of Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh and West Bengal – the same states covered in the World Health Survey (WHS) India 2003. Given the remarkable variation in population health indicators across the states of India, the WHS India project team decided to generate state-level estimates, as well as providing pooled estimates for the country. The same primary sampling units and the sample households covered in the WHS were the baseline sample for SAGE India Wave 1; consequently, in India, the WHS is also used as SAGE Wave 0.


Sample design

SAGE Wave 1 India follows the same households from the same primary sampling units used by the International Institute for Population Sciences when undertaking the WHS/SAGE Wave 0 India in 2003. WHS/SAGE Wave 0 was conducted in randomly selected six states – Assam, Karnataka, Maharashtra, Rajasthan, Uttar Pradesh and West Bengal – covering an overall sample of 10,279 households. The survey focused on one adult (any person over 18 years) in each household. This individual was randomly selected using Kish grid tables, which helped to select the respondent in the household without any bias to a particular age or sex group. A systematic random sample selection process was undertaken for the WHS/SAGE Wave 0 that included all states in India. States with a population of five million or more, except Jammu and Kashmir, were grouped into six geographical regions: north, central, northeast, east, west and south. Jammu and Kashmir were not included because of the difficulty of conducting household interviews in these areas. All the states were further classified into six groups according to level of development, based on four important indicators: infant mortality rate, female literacy rate, percentage of safe deliveries (births) and per capita income. The infant mortality rate is a good summary indicator of an area’s level of development in terms of mortality and health transition. The female literacy rate is an important determinant of utilization of different services by mothers, and can also be used as a proxy measure of their families’ likelihood to use health care services. Percentage of safe deliveries indicates the extent of utilization of health care services and is an important determinant of maternal mortality. Per capita income is commonly used as an indicator of economic development. The six states randomly chosen for the WHS/SAGE Wave 1 include one state from each geographical region as well as from each level of development.

 

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