Psychometrics Validation of the WHO-5 Wellbeing Index in Botswana, Zimbabwe, and Malaysia: Coping With COVID-19 Pandemic in the Global South Study

Abstract

COVID-19 and the actions to curtail its spread have elevated the value of mental health as well as public health crises and pandemics. This calls for increased research in this area and the use of consistent and valid instruments to measure diverse aspects of mental health in different populations. This study presents preliminary psychometric properties (i.e., factor structure, internal consistency, convergent and discriminant validity) of the WHO-5 index as compared to other mental health instruments used in three countries (Botswana, Zimbabwe, and Malaysia). Data was collected from three countries during the first 5 months after the onset of COVID-19 in the Southern African and Southeast Asia regions: Botswana ( N = 422; Mean Wellbeing = 9.8; SD = 5.4), Zimbabwe ( N = 325; Mean = 9.4; SD = 5.3), and Malaysia ( N = 425; Mean = 13; SD = 5.3). After data quality and scaling properties were evaluated, factor structures were assessed using principal component analysis and internal consistency of the extracted components were examined using Cronbach’s alpha (α). Construct validity was examined using Pearson’s correlations to establish both convergent validity and discriminant validity among the three mental health constructs (i.e., well-being, generalized anxiety, and loneliness). With Cronbach’s alpha of the total WHO-5 Wellbeing index of .86 (Botswana sample), α = .85 (Zimbabwean data) and α = .88 (Malaysian data), as well as (α > .7) for the selected demographic subgroups, the findings broadly suggest that WHO-5 is a unique, reliable, and valid instrument for measuring subjective well-being, and by extension mental health among diverse subgroups—in Botswana, Zimbabwe, Malaysia, and possibly, other similar settings.