Global Health Action Supplement 2, 2010 CONTENTS Forewords INDEPTH WHO-SAGE study Osman Sankoh 2 The INDEPTH WHO-SAGE collaboration Á coming of age Ties Boerma 3 Guest Editorial The INDEPTH WHO-SAGE multicentre study on ageing, health, and well-being among people aged 50 years and over in eight countries in Africa and Asia Richard Suzman 5 Participating Sites - List of Staff 8 Ageing and adult health status in eight lower-income countries: the INDEPTH WHO-SAGE collaboration Paul Kowal, Kathleen Kahn, Nawi Ng, Nirmala Naidoo, Salim Abdullah, Ayaga Bawah, Fred Binka, Nguyen T.K. Chuc, Cornelius Debpuur, Alex Ezeh, F. Xavier Go´mez-Olive´, Mohammad Hakimi, Siddhivinayak Hirve, Abraham Hodgson, Sanjay Juvekar, Catherine Kyobutungi, Jane Menken, Hoang Van Minh, Mathew A. Mwanyangala, Abdur Razzaque, Osman Sankoh, P. Kim Streatfield, Stig Wall, Siswanto Wilopo, Peter Byass, Somnath Chatterji and Stephen M. Tollman 11 Assessing health and well-being among older people in rural South Africa F. Xavier Go´mez-Olive´, Margaret Thorogood, Benjamin D. Clark, Kathleen Kahn and Stephen M. Tollman 23 Health status and quality of life among older adults in rural Tanzania Mathew A. Mwanyangala, Charles Mayombana, Honorathy Urassa, Jensen Charles, Chrizostom Mahutanga, Salim Abdullah and Rose Nathan 36 The health and well-being of older people in Nairobi’s slums Catherine Kyobutungi, Thaddaeus Egondi and Alex Ezeh 45 Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana Cornelius Debpuur, Paul Welaga, George Wak and Abraham Hodgson 54 Patterns of health status and quality of life among older people in rural Viet Nam Hoang Van Minh, Peter Byass, Nguyen Thi Kim Chuc and Stig Wall 64 Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level Abdur Razzaque, Lutfun Nahar, Masuma Akter Khanam and Peter Kim Streatfield 70 Health and quality of life among older rural people in Purworejo District, Indonesia Nawi Ng, Mohammad Hakimi, Peter Byass, Siswanto Wilopo and Stig Wall 78 Social gradients in self-reported health and well-being among adults aged 50 and over in Pune District, India Siddhivinayak Hirve, Sanjay Juvekar, Pallavi Lele and Dhiraj Agarwal 88 Health inequalities among older men and women in Africa and Asia: evidence from eight Health and Demographic Surveillance System sites in the INDEPTH WHO-SAGE study Nawi Ng, Paul Kowal, Kathleen Kahn, Nirmala Naidoo, Salim Abdullah, Ayaga Bawah, Fred Binka, Nguyen T.K. Chuc, Cornelius Debpuur, Thaddeus Egondi, F. Xavier Go´mez-Olive´, Mohammad Hakimi, Siddhivinayak Hirve, Abraham Hodgson, Sanjay Juvekar, Catherine Kyobutungi, Hoang Van Minh, Mathew A. Mwanyangala, Rose Nathan, Abdur Razzaque, Osman Sankoh, P. Kim Streatfield, Margaret Thorogood, Stig Wall, Siswanto Wilopo, Peter Byass, Stephen M. Tollman and Somnath Chatterji 96 In addition to the mentorship and editing provided by the Supplement Editors, each paper has been subjected to regular peer review. FOREWORD æ INDEPTH WHO-SAGE Supplement INDEPTH WHO-SAGE study y foreword to the first INDEPTH supplement establish a training centre for health and demographic published in GHA, which comprised a series of surveillance systems so that many more scientists from Mpapers by the INDEPTH NCD Surveillance in low- and middle-income countries could be trained in Asia Working Group, stated that the work demonstrated complex longitudinal data analysis techniques. ‘the increasing ability of the INDEPTH Network to On behalf of the INDEPTH Board and myself, I wish to harness the collective potential in Health and Demo- thank the World Health Organization who have been graphic Surveillance Systems in low- and middle-income exemplary partners in this collaboration, and also the key countries to provide a better, empirical understanding of funder, National Institute on Aging and National Institutes health issues of populations under continuous evaluation.’ of Health (NIA, NIH). I wish to highlight the pivotal role In that foreword I also noted, ‘with that collaborative played by Dr. Richard Suzman (NIA, NIH) who ‘was research, we have seen some of the objectives of always there’ as a funder and competent scientist during INDEPTH being achieved: we have strengthened the this collaboration and is the Senior Editor of this Supple- capability of several of our young scientists to conduct ment. I also want to acknowledge the Health and Popula- and analyse longitudinal health and demographic studies; tion Division, School of Public Health, University of the and some of them have become first authors of scientific Witwatersrand, South Africa, for its ongoing role as papers for the first time’ (1). satellite secretariat of the INDEPTH Adult Health and The current supplement, by the INDEPTH Adult Ageing Working Group. This multi-site and multi-country Health and Ageing Working Group, is a compilation of a INDEPTH project has succeeded because of the commit- series of excellent site-specific and cross-site papers, ment and scientific leadership of Professor Stephen Toll- which has reinforced the opinions I expressed previously. man, the leader of the INDEPTH Adult Health and Ageing I feel privileged to be writing these forewords at a time Working Group. Furthermore, I wish to appreciate the when these studies are being completed and their results advice provided by the INDEPTH Advisory Committee through its member Professor Stig Wallat Umea˚University. are being disseminated in scientific publications. The Through resources provided for core institutional INDEPTH WHO-SAGE collaboration started several support to INDEPTH by the Wellcome Trust, Sida/ years ago during the tenure of office of my predecessor, GLOBFORSK, Rockefeller Foundation, Gates Founda- Professor Fred Binka. It was he who provided the initial tion and Hewlett Foundation, we were able to contribute support to the Adult Health and Ageing group, enabling financially to the Adult Health and Ageing Working it to engage with WHO in this partnership. I therefore Group for the successful completion of this work. I was wish to share with him the credit for this success. happy to learn of WHO’s success in securing further I am delighted to have taken part in two key analysis resources from NIA, NIH for a Phase II of these workshops graciously hosted by the Umea˚ Centre for INDEPTH WHO-SAGE studies and, in this regard, Global Health Research, Umea˚ University, Sweden in look forward to our continuing collaboration. 2008, and by the Harvard Centre for Population and The dataset generated by these studies is being made Development Studies, Cambridge, MA, USA in 2010. I am freely available and INDEPTH will encourage wider use also well aware of those previously hosted by the University of the data. of Witwatersrand’s School of Public Health as well as the WHO, more recently in June 2010. I saw INDEPTH Congratulations! scientists presenting their work and taking part in rigorous data analysis, and witnessed exemplary collaboration Osman Sankoh demonstrated by our partners in Umea˚ and Boston. Executive Director, INDEPTH Network They contributed expertise and resources to strengthen the capacities of our scientists to take leading roles in this work. Reference While in Umea˚ and Boston, I saw our colleagues there demonstrating expertise in data analysis and in how to 1. Sankoh O. Foreword. Global Health Action Supplement 1, 2009. interrogate and make sense out of data that had been DOI: 10.3402/gha.v2i0.2085 collected thousands of miles away. That experience made me feel that there was a great need for INDEPTH to Global Health Action 2010. # 2010 Osman Sankoh. This is an Open Access article distributed under the terms of the Creative Commons Attribution- 2 Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Global Health Action Supplement 2, 2010. DOI: 10.3402/gha.v3i0.5441 FOREWORD æ INDEPTH WHO-SAGE Supplement The INDEPTH WHO-SAGE collaboration Á coming of age t is no surprise that there is a lack of evidence on the data. INDEPTH sites have relatively large populations health of older populations in low- and middle- under surveillance with regular monitoring of vital events, Iincome countries. Much current attention is focused which allows the inclusion of a standard short module to on the Millennium Development Goals, prioritising examine health and health-related outcomes in regular maternal and child health and leading infectious diseases. surveillance rounds. In addition, innovative strategies can The epidemiological transition is relatively recent and be developed to link survey and surveillance data to inform health researchers and policy-makers are still grappling larger national estimates as well as developing and testing with the new data demands. And even in high-income strategies for robust small area estimates. In three of the countries, which face increasingly large older populations eight countries with sites Á Ghana, India and South Africa and predominance of chronic diseases, there are major Á reported in this volume of Global Health Action (GHA), evidence gaps. national SAGE studies are ongoing. The set of papers in this Supplement represent a The collaboration will also draw upon the expertise significant step towards better evidence on the health within INDEPTH sites to improve methods