INDICATORS OF HEALTH

PRESENTED BY: POOJA SANALKUMAR

HEALTH INDICATOR is a variable, susceptible to direct measurement, that reflects the state of health of the subjects in a community

VALID RELIABLE SENSITIVE SPECFIC FEASIBLE RELEVANT

CHARACTERISTICS

Measurement, Description and Comparison of the health of the community.

Identification of health needs & prioritizing them.

Planning & allocation of health resources. Measurement of health successes.

USES OF INDICATORS

Mortality indicators Indicators of social and mental health

Morbidity indicators Environmental indicators

Disability rates Socio-economic indicators

Nutritional indicators Health policy indicators

Health care deliveryindicators

Indicators of quality of life

Utilization rates Other indicators

CLASSIFICATION

Crude Death Rate Expectation Of Life Age Specific Death Rate Infant Mortality Rate Child Mortality Rate Under 5 Proportionate Mortality Rate Adult Mortality Rate Maternal Mortality Rate Disease Specific Mortality Rate Proportional Mortality Rate Case Fatality Rate Years Of Potential Life Lost

MORTALITY INDICATORS

Number of deaths per 1000 population per year in a given community.

Fair indicator of health. ↓ death rate – assesses health

improvement in a community the overall.

CRUDE DEATH

Life expectancy at birth : the average number of years that will be lived by those born alive into a population if the current age-specific mortality rates persist.

In India,◦ Male 63.8◦ female 67.3

EXPECTANCY OF LIFE

INDIA JAPAN NEPAL USA0102030405060708090

100

6580

6776

68

86

6981

Males Females

LIFE EXPECTANCIES IN COUNTRIES

Source – K.Park, Fertility, Park’s Textbook of social and preventive medicine, 2015, 23rd Edition, M/s Banarsidas Bhanot, India

MP UP

Tamil N

adu

Mahara

shtra

Keral

aPu

njab

020406080

58 60 66.2 67.2 74 69

Life Expectancy

IN DIFFERENT STATES OF INDIA

Source: http://populationcommission.nic.in/content/932_1_TablesMapsAndBarCharts.aspx , accessed on June 2nd 2015

The ratio of deaths of children under 1 year of age in a given year to the total number of live births, in the same year.

Usually expressed as rate per 1000 live births.

Sensitive indicator of availability,utilisation and effectiveness ofhealth care, particularlyperinatal care.

INFANT MORTALITY RATE

54%

16%

4%

5%

2% 3%

17% Low Birth Weight

Respiratory infections

diarrhoeal disease

congenital malforma-tions

cord infection

birth injury

unclassified

CAUSESIN INDIA

India Sri Lanka Bangladesh Pakistan US China0

20

40

60

80

100

120

IN COUNTRIES (1990-2013)

Assam Karnataka Punjab Delhi Kerala010203040506070

Infant Mortality Rates

IN DIFFERENT STATES

Improved obstetric and perinatal care (availabity of oxygen, foetal monitoring during labour)

Improvement in quality of life(social and economic progress)

Better control of communicable diseases(immunisation)

Better nutrition(emphasis onbreast feeding) Family planning(birth spacing)

DECLINE IN INFANT MORTALITY RATE

Number of deaths at age of 1-4 years in a given year, per 1000 children in that age group at the mid-point of the year.

Correlates with inadequate MCH services, low coverage by immunisation & adverse environmental exposure.

CHILD MORTALITY RATE

The proportion of total deaths occurring in the under-5 age group.

Reflects both infant and child mortality. In India, 59/1000 In China, 18/1000

UNDER-5 PROPORTIONATE MR

Number of maternal deaths in a given period per 100,00 women of reproductive age during the same time period.

Accounts for the greatest proportion ofdeaths among women of reproductive age in most developing countries.

MATERNAL MORTALITY RATE

8%5%5%

11%

38%

34%

IN INDIA

AbortionObstructed labourHypersensitive disordersSepsisHaemorrhageOther conditions

CAUSES

US China Pakistan India Myanmar0

50

100

150

200

250

28 32

170 178200

Maternal Mortality Rate

IN DIFFERENT COUNTRIES

MP Karnataka Punjab Kerala0

50

100

150

200

250

21.1 8.1 9 3.3

230

144 155

66

Maternal Mortality Rate/100,00 birthsMaternal Mortality Ratio

IN STATES OF INDIA

Estimates the burden of a disease in a community.

Example, Coronary heart disease – 25 to 35% of all deaths in western countries.

Other Mortality indicators are case fatality rate and Years Of Potential Life Lost(YPLL).

PROPORTIONAL MORTALITY RATE

Extrication of communicable diseases

Other indicators emerged, like in deaths from cancers, cardiovascular diseases, accidents, diabetes, etc.

DISEASE SPECIFIC MR

Incomplete reporting of deaths

Lack of accuracy (recording age and cause of death)

Lack of uniformity and standardised method of data collection.

LIMITATIONS OF MORTALITY DATA

Any departure, subjective or objective, from a state of physiological well being.

Used to supplement mortality data to describe the health status of a population

MORBIDITY INDICATORS

Following morbidity rates are used:◦ Incidence and prevalence◦ Notification rates◦ Attendance rate at the O/P dept.◦ Admission, readmission & discharge dates◦ Duration of stay in hospital◦ Spells of sickness/absence from work/school.

Disability is defined as “any restriction or lack of ability to perform an activity in a manner or within the range considered normal for a human being.”

Types : (1)Event type indicators (2)Person type indicators

DISABILTY RATE

Event-type indicators Person-type indicators

Number of days of restricted activity

Bed disability days Work-loss days

within a specific period

Limitation of mobility (confined to bed/ house)

Limitation of activity

Based on life expectancy at birth and includes an adjustment for time spent in poor health.

It is the equivalent number of years in full health a new born can expect to live based on current rates of ill health and mortality.

HEALTH-ADJUSTED LIFE EXPECTANCY (HALE)

Used for assessing value for money of medical intervention

Values : perfect health = 1.0 death = 0.0

Therefore, 1 QALY=1 year of life x 1 unity value.

QUALITY ADJUSTED LIFE YEARS (QALY)

Measure of overall disease burden, expressed in number of years lost due to ill health or early death.

Daly combines: Years of Lost Life (YLL) and Years Lost to Disability (YDL)

DALY= YLL + YLD

DISABILITY ADJUSTED LIFE YEARS (DALY)

3 Nutritional Status indicators considered important are:◦ Prevalence of low birth weight (2.5 kg)◦ Height and weight of children at school entry◦ Anthropometric Measurement of preschool

children

NUTRITIONAL STATUS INDICATORS

Reflects the equity of distribution of health resources in different parts of the country, and of provision of health care.

Frequently used indicators:◦ Doctor-population ratio◦ Doctor-nurse ratio◦ Population-bed ratio◦ Population per health/sub centre◦ Population per traditional birth attendant

HEALTH CARE DELIVERY INDICATORS

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