Indicators of health
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Transcript of Indicators of health
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
THANKYOU