Wellbeing and Quality of Life Assessment: A Practical Guide

Wellbeing and Quality of Life Assessment: A Practical Guide

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Overview

Wellbeing and Quality of Life Assessment is a practical resource for people working in social or development policy and practice who are thinking about integrating wellbeing or quality of life in their work in both the global North and South.

The main body of the book presents different tools that have been developed and used in social and development policy and practice, written by NGO professionals. These chapters outline the inspiration behind their approach, how it works, what has been learned through it, and issues and dilemmas that remain.

Human development may encompass social, cultural and spiritual facets as well as economic improvement, and development organizations are beginning to recognize this fact. But building into programming a wider understanding of development throws up a number of questions: how do our organizations define wellbeing and quality of life? What do target communities in the global north or south mean by a quality of life? How can we measure change in wellbeing, and attribute it to our programming?

Product Details

ISBN-13: 9781853398421
Publisher: Practical Action Publishing
Publication date: 12/01/2014
Pages: 212
Product dimensions: 6.12(w) x (h) x 1.00(d)

About the Author

Sarah C. White is a senior lecturer at the University of Bath. She has more than ten years’
experience researching wellbeing in developing countries.

Robert Chambers is Research Associate and Emeritus Professor, Institute of Development Studies, University of Sussex and the author of Participatory Workshops (2002) and Ideas for Development (2005).

Asha Abeyasekera is a lecturer at the Faculty of Graduate Studies, University of Colombo, Sri Lanka. She has worked for more than ten years as a practitioner in the development sector.

Read an Excerpt

CHAPTER 1

Introduction: why wellbeing?

Sarah C. White

This chapter provides a basic introduction to wellbeing in international development. It identifies wellbeing as a field of ideas and describes the main characteristics of these and how they fit within international development. It then discusses some of the different reasons that focusing on wellbeing is attractive to policy makers and practitioners, and some of the politics of the different approaches. It then provides a brief description of the main thinking behind some key terms: subjective wellbeing, psychological wellbeing, happiness, and quality of life.

Keywords: wellbeing, international development, policy and practice, quality of life

Introduction

Happiness, wellbeing, and quality of life seem to be all the rage. From the Government of Bhutan's commitment to measure Gross National Happiness, to the United Nations' 2011 Happiness Resolution, to the New Economics Foundation's Happy Planet Index, to Gallup World Poll rankings of countries by happiness, to the Organisation for Economic Co-operation and Development's (OECD's) Better Life Index, to the UK's Office for National Statistics' collection of data on subjective wellbeing, to indigenous movements in Latin America mobilizing around buen vivir, or 'living well', to government programmes, organizational missions, customer surveys, and staffing policies – everywhere, it seems, there is increasing convergence in identifying the promotion of wellbeing or happiness as the ultimate objective.

But what does this really mean? Have we suddenly woken up to a global consensus on what really matters in life? Are we all, at last, pulling in the same direction? Or are the same words being used to mean very different things? And if so, how can we get better at understanding who is really saying what? And how might we want to define and work towards improving wellbeing or quality of life for ourselves?

This book is intended as a practical resource for people engaged in social or development policy or practice who are thinking about integrating wellbeing or quality of life in their work. It is written by a group of researchers and nongovernmental organization (NGO) staff who gathered together to share their experiences of working on wellbeing or quality of life at the community level, mainly, but not exclusively, in the global South. We do not aim to give you all the answers – we do not have them ourselves. Instead, we hope to provide practitioners with a concise introduction to the field of wellbeing and quality of life, suggest some key questions to think about when working in this area, and present a number of different frameworks for readers to consider, adopt, or adapt in developing their own.

• Part One provides a brief introduction to key concepts and issues.

• Part Two presents a number of assessment tools that have been developed by NGOs and researchers and describes the experience of putting them to use.

• Part Three reflects on using wellbeing in policy and advocacy.

• Part Four draws together what has been learned and considers how this fits within policy and politics more broadly. The book closes with a list of further resources.

Wellbeing and quality of life: what do they mean?

Wellbeing and quality of life describe a field of associated ideas, rather than a single concept or definition. At their root, they concern what it means for life to be good. How people see this differs from person to person, including by geography, history, and culture, between men and women, by community, personality, and time of life. It is not possible, then, to give a universal definition of what wellbeing means. In fact, it is important not to do this, but to make space for people within a particular setting to define what wellbeing or a good quality of life means for them.

As a field, wellbeing and quality of life approaches share a number of common characteristics:

multi-dimensional: going beyond the economic to a broader understanding of what makes life good;

positive: an orientation towards people's strengths and resources, rather than vulnerabilities and what is lacking;

personal: concerned with the impact on people's lives, rather than the narrow achievement of project or programme objectives;

focus on quality of life: what people get out of it rather than what they have;

focus on experience and enjoyment: people's subjective perceptions, not just objective achievements.

While people may define wellbeing in quite different ways, there is considerable agreement about the factors that contribute to it. These include: material sufficiency; a dependable and attractive physical environment; good personal and social relationships; dignity and respect; meaningful activity; safety and security; mental and physical health; scope for agency; a positive sense of self; and spiritual nourishment.

Locating wellbeing and quality of life in international development

While the labelling is new, work on wellbeing and quality of life takes forward already well-established trends. The most obvious of these is the move to recognize poverty and development in multidimensional terms. It also builds on and advances the insights of livelihoods approaches, which see people's economic activity as a complex mix of priorities, strategies, influences, activities, and alliances that draw on a range of material and social resources. Like livelihoods approaches, a focus on wellbeing promotes an actor-oriented approach that emphasizes people's strengths rather than their needs. In common with Amartya Sen, wellbeing sees living standards as related not simply to what you have, but to what you can do and be – his 'capabilities and functionings'. From green politics and the sustainability movement comes the importance of considering environmental protection and promotion as being at the heart of wellbeing. The health sector locates health within a broader concern with quality of life; and intervention in situations of violent conflict and disasters has brought attention to the psychological and the psychosocial. Work on participation shows the importance of listening to local perspectives and ensuring that local people participate actively in shaping the change that is to come. This also draws attention to the fact that it matters not just what change is brought about, but also how it is done. Finally, feminist work on women's empowerment brings sensitivity to the impact of personal relationships, self-confidence, how people imagine themselves, and, more generally, the politics of the personal.

In practical terms, wellbeing or quality of life assessment may be used in conjunction with other tools or frameworks, such as participatory research or gender analysis.

Why work on wellbeing and quality of life?

There are a number of different reasons that explain why a focus on wellbeing is attractive to policy makers and practitioners. This section identifies some of the key issues, and introduces some of the politics in how they may be pursued.

From project-centred to people-centred

In project or programme monitoring and evaluation, wellbeing shifts the focus from the achievement of project objectives to the impact on people's lives. There may be informal evidence that projects have had a broader effect in terms of more generalized empowerment, for example, that may have a significant effect on the sustainability of the project. A wellbeing assessment offers an opportunity to track these effects in a systematic way. This is attractive not only in giving a fuller picture of what the programme or project has achieved, but also in putting people's own perspectives at the centre.

• Wellbeing assessment may be used to identify local understandings and priorities.

• Assessing wellbeing means broadening the scope to include aspects of life that the project is not working on directly. This can help identify unexpected consequences of the programme, both good and bad. It may also highlight important issues for further action, not considered in the project design.

• Subjective dimensions are included alongside – or perhaps instead of – objective dimensions. Objective here means dimensions that can be assessed by external observation, such as quality of housing or level of schooling achieved. Subjective refers to issues that only the people themselves can provide information about – how they are thinking or feeling about their lives.

• Relationships, among staff and between staff and clients, come into sharper focus. Do the ways in which people relate to each other foster wellbeing? This encourages reflexive practice.

• Ideally, assessment involves a participatory process, in which people are asked to determine what matters to them and what the indicators should be.

The practical issues that need to be addressed in making this shift are discussed in Chapters 2 and 3.

A positive and inclusive approach

A further attraction of working on wellbeing is its positive charge. This replaces the default negative orientation of many social and development programmes, which emphasize deficiency and what people lack, rather than their strengths or hopes.

• Wellbeing is an issue for everyone. It therefore helps to break down the divisions between those who deliver programmes and those who are the recipients of them. These divisions mean that programmes can often carry stigma and disrespect along with aid.

• An emphasis on hopes and possibilities can bring a new positive energy and unlock old prejudices and habits of thought. For example, a group from a run-down housing estate in London was asked to participate in mapping their area for inclusion on an internet site. The initial idea of highlighting dangers and deprivation fell on its face: people didn't want to add to the bad publicity already surrounding the place where they lived. But when the plan was changed to make it a celebration of the area and the people who lived there, people joined in enthusiastically. Working together on the project helped them see their neighbourhood differently, and encouraged them to think about how they could improve it.

• Authenticity is a major issue here. It is easy for positive rhetoric simply to gloss over old patterns, leaving them unchallenged. It is also important that the negatives in people's lives are faced honestly and addressed.

• In addition, emphasizing people's strengths should not become a cover for denying them the support they need. For example, many people living in poverty in disaster-prone regions of Bangladesh are without doubt resilient and resourceful. However, this does not mean that they should be left to cope with their hazardous environments with no outside support.

Beyond GDP

The limitations of using national economic growth as the main development indicator have long been recognized. Wellbeing provides a more rounded, more comprehensive focus. There are, however, very different views as to where this leads. The strength of wellbeing at this level is its broad appeal. But this is also its weakness, leaving it open to capture by very different political agendas.

• Some see wellbeing as giving additional, complementary indicators (for example in health or education) with economic growth still in primary place.

• For others it raises questions of what is 'good growth': that the economy should be developed in ways that serve human fulfilment and are environmentally sustainable.

• Others use wellbeing to argue for a new economic model that promotes material sufficiency rather than growth, with alternative values such as social justice, environmental integrity, and human fulfilment at the centre.

A universal indicator?

Paradoxically, wellbeing may also be attractive to policy makers for quite the opposite reason: not breadth, but parsimony, or slimness. This is where 'happiness' comes in. If the ultimate aim of government policy is to enhance wellbeing, and if the best guide to people's wellbeing is how happy they are, then a single measure of happiness can seem a composite indicator of how successful government policy as a whole has been.

The idea of the purpose of public policy being to increase happiness (or 'utility') is not a new one: it goes back at least to the 18th and 19th centuries, and the Utilitarian philosophy of Jeremy Bentham and John Stuart Mill. What is new is the claim that, after long having to settle for income as a proxy for happiness, in 'subjective wellbeing', economists have at last a direct, quantifiable measure of pure utility. This is why the promise of direct measures of 'how people think about and experience their lives' (OECD, 2013: 3) causes such excitement in statistics offices across the globe.

To have a measure of pure utility would bring two great advantages. First, it would give a generic measure, not specific to any particular programme or project. This could then provide a common basis on which to judge the effectiveness of – and so choose between – very different kinds of intervention. Second, it could be seen as a global indicator, which could be used to assess the impact not of a single programme on its own, but of the entire range of government policy.

You will have noticed, however, that there were a lot of 'coulds' in the last paragraph. They were there for good reason. There are many grounds to doubt whether a single indicator of happiness – or even a combination of three or four questions combination – should be used in this way:

• It is difficult to know what such questions are really telling you. Is one person's 'fairly happy' the same as another's, perhaps in a completely different country context? Aside from such issues as personality or the mood of the moment, studies have shown that culture influences the way such questions are answered.

• The way people answer such questions depends heavily on issues including the order in which questions are asked, the number of options given as answers, and so on.

• Also, people may not say what they feel, but what seems 'the right thing' or what will make them look good, or – if they are being questioned in the context of an intervention – what seems most likely to secure further assistance. Of course, these issues arise with all kinds of questions, not just those concerning happiness.

• Happiness questions are very vulnerable to political manipulation, which makes them bad indicators for policy. People can be coached and questions can be framed in ways that will result in higher scores. People wishing to register a protest, on the other hand, can easily use such measures to do so.

• Even if you can get an accurate measure of how people are feeling, this is influenced by a wide range of factors other than the projects and programmes you have sponsored or implemented. Identifying people's happiness with the impact of your project or programme is therefore a major act of faith.

Wellbeing, happiness, or quality of life?

The paragraphs above show that wellbeing, happiness, and quality of life may be interpreted in many different ways. It is important to pay attention to the politics of how these terms are being used, as they can be made to serve very different interests. This is discussed further in Chapter 12. But what about the words 'wellbeing', 'happiness', or 'quality of life' themselves? Some commentators favour one term over another and others mix and match between them. Are there any rules about what the terms mean and how they differ?

The short answer is that there are no universally agreed definitions. There is a general consensus that happiness is essentially subjective, while wellbeing and quality of life may have both objective and subjective dimensions. Beyond this, which term is used primarily reflects a given disciplinary or institutional history. For example, in this volume some contributors talk of wellbeing, some of quality of life, but we all share a great many perspectives in common. The paragraphs that follow introduce some of the main approaches to wellbeing, happiness, and quality of life in the wider literature. Part Four provides suggestions of further resources.

The literature on wellbeing, happiness, and quality of life is large. It covers a range of disciplines from philosophy, through psychology, economics, health, and social statistics, to sociology and anthropology. Each discipline has its own areas of attention and inattention. For example, economics may have an extensive household survey with just a single question on happiness; psychology may do complex statistical analyses of subjective wellbeing scores, but pay scant attention to the social or economic characteristics of respondents. They all share, however, a yearning towards objective data, and an ambition to be policy relevant.

Wellbeing is often used in quite a general way, simply to indicate a broad-based concern with how people are doing. Figure 1.1 shows the main, more specialist approaches to wellbeing and quality of life, which include a subjective dimension of people's own perspectives on their lives.

(Continues…)


Excerpted from "Wellbeing and Quality of Life Assessment"
by .
Copyright © 2014 Sarah C. White with Asha Abeyasekera and the contributors.
Excerpted by permission of Practical Action Publishing.
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Table of Contents

About the editors,
Acknowledgements,
Foreword by Robert Chambers,
PART ONE: Introduction to wellbeing and quality of life: ideas, issues, and choices,
1 Introduction: why wellbeing? – Sarah C. White,
2 Key issues in wellbeing and quality of life assessment – Sarah C. White,
3 Practical choices in designing a wellbeing and quality of life assessment – Sarah C. White,
PART TWO: Wellbeing and quality of life in development practice,
4 A social justice approach to wellbeing: the PADHI psychosocial framework – Asha Abeyasekera,
5 Inner wellbeing: the Wellbeing and Poverty Pathways approach –Sarah C. White and Shreya Jha,
6 Traidcraft: assessing human flourishing – Lizzie Spencer, George Williams, and Liza Stevens,
7 CAFOD: quality of life Batteries Tool – Harriet S. Jones,
8 Trócaire: measuring change, person wellbeing, and programme impact using the Wheel – Fiona O'Reilly,
PART THREE: Wellbeing and quality of life in policy and advocacy,
9 The potential for a wellbeing approach in policy making and sustainable development – A. Michael Warhurst,
10 Oxfam's Humankind Index – Katherine Trebeck and Asha Abeyasekera,
11 Wellbeing Wales: the Sustainable Wellbeing Framework – Dafydd Thomas,
PART FOUR: Going forward,
12 Conclusion: the politics of working on wellbeing – Sarah C. White,
Further resources on wellbeing and quality of life,
Index,

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