HealthIndicators for the national TB program .ppt

NTP indicators

1. Health Indicators
Dr.Esam Mahyoub
Community Medicine

2. Health Indicators
Health indicators are used to measure
health of a community
Health indicators can be used to compare
health of two communities
It can be used to assess the health needs of a
community
It is useful for monitoring and evaluation of
health programmes

3. Qualities of an ‘indicator’
Validity –The indicator should measure
what it is supposed to measure
Reliability –It should give the same value
when measured by different people
Sensitivity –It should show the changes in
the situation

4. Health indicators
Mortality indicators
Morbidity indicators
Disability rates
Nutritional status indicators
Health care delivery indicators
Socio-economic indicators
Indicators of quality of life

5. Rates
With rates, the numerator is included in
the denominator
Rate is the number of or frequency of a
disease per unit size of population

6. Ratios
Ratio –the relation in number, degree
or quantity existing between two similar
things
25 ♀: 30 ♂

7. Proportions
Compare like populations or like
illnesses within a population
For example, 40 children are currently ill
with measles, while 80 children all together
have or had the measles

8. Mortality indicators
Crude death rate
Specific death rate
Case fatality rate
Expectation of life
Infant mortality rate
Maternal mortality rate

9. Crude death rate
‘is the number of deaths (from all causes)
per 1000 estimated mid-year population in
one year, in a given place’
Number of deaths during a year
Mid-year population
X 1000

10. Specific death rate
Is the death rate due to a specific disease,
or in a specific age or sex group etc.
Specific death rate due to Tuberculosis
Number of deaths due to Tuberculosis
during a year
Mid-year population
X 1000

11. Case fatality rate
It is the number of people dying due to a
specific disease.
It shows the severity of the disease
Number of deaths due to a disease
Total number of cases due to the
disease
X 100
%

12. Infant Mortality Rate (IMR)
Number of infant deaths in a year per
1000 live births
Number of deaths of children less than
1 year of age in a year
Number of live births in the same year
X 1000

13. Infant Mortality
Infant mortality rates are the most
commonly used rates for measuring
the risk of dying during the first year
of life.
Most frequently used measure for
comparing health services among
nations.
Indicator of the level of health in a
community

14. •Neonatal Mortality Rate (NMR):
–Is the number of deaths of infants during their first
month (or 4 weeks) per 1000 live births in a certain
locality and year.
•Post –neonatal Mortality Rate:
–Is the number of deaths of infants from one month
to one year of age per 1000 live births in a certain
locality (or country) and year.
•Children 1-4 years Mortality:
–It is age specific mortality of preschool children and
so called preschool child mortality. It is the number
of death of children aged 1-4 years per 1000
children of the same age group in a given locality
or country and year
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15. •PerinatalMortality Rate:
–Perinatalperiod: is the period around labourfrom
28th week of pregnancy to the end of first week
after labour.
–PerinatalMortality Rate: It is the number of death
occurring in the perinatalperiod, after 28th week of
pregnancy to the end of first week after labourper
1000 live born in a given locality and year.
•Stillbirth Rate:
–Stillbirth is a viable fetus delivered after the 28th week of
pregnancy without showing any sign of life after being
completely expelled from mother.
–Stillbirth rate is the number of fetal deaths after the 28th
week of pregnancy per 1000 livebornin a locality and
year.
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16. Maternal Mortality Rates
There is no system for gathering
information for all pregnancies -the
closest useful measure is the number of
live births. MMR =
# deaths in a year from puerperal causes
# of live births in the same year
Denominator does not include all
pregnancies, but number of live births

17. Other indicators
Birth Rate
Fertility Rate

18. 1-Birth Rate
Crude Birth Rate (CBR): Is the No. of live births per
1000 population of certain locality and year.
18

19. 2-Fertility Rate
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20. Total Fertility Rate:
The average number of children that would
be born to women surviving until
menopause.
Birth rate is generally high in developing
countries including Yemen, due to:
1-High fertility rates due to social and traditional
motives.
2-Poor family planning facilities
3-Factors related to marriage (the youngest
age of marriage is associated with long
childbearing period).20

21. Measurements of Morbidity
Incidence
Prevalence

22. What is incidence?
The incidence is the number of NEW CASES
of disease that develop, in a population of
individuals at risk, during a specified time
period
Usually expressed as the number of new
cases, per 100,000 population per year

23. Example : Measuring incidence
Incidence of cervical cancer in a PHC during 2002
Number of new cases during 2002 = 18
Number of disease free persons (‘population at risk’) at the
beginning of 2002 = 200,000
Incidence is (18/200,000) x 100,000
9 cases of cervical cancer per 100,000 in 2002
N.B. The denominator might be taken as the population at risk at the
beginning, or the mid-point of the year, or the total person-time at risk

24. Incidence
There are 500 new cases of Hepatitis in a city
with a population of 30,000 in 2008
Incidence of hepatitis =
The Incidence rate MUST contain the time
period
500
30,000
X 1000
= 16.7 per 1000 per
year

25. What is prevalence?
Prevalence is the total number of EXISTING CASES of
disease in a population at one point in time.

26. Prevalence
Prevalence is expressed as a proportion
(0-100%)
…or as a rate
(e.g. X cases per 100,000 population)
It does not take into account WHEN people
became infected / diseased

27. Example : Incidence and prevalence
Cases of cold infections in class 4J. Class size: 20
January February
March
What is the period prevalence during February?
What is the incidence in February?
6/20 = 30%
4/?

28. Incidence and prevalence
Sick population
(Prevalence)
Healthy
population
Incidence (new cases)
die (mortality)
recover

29. Summary
Health indicators are used for measuring
the health status of a community
It can also be used to compare health
status of two countries or the same
country between two time periods
There are many mortality and morbidity
indicators

30. Exercise
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31. Calculate
1. Crude Birth Rate
2. Crude Death Rate
3. Infant Mortality Rate
4. Maternal Mortality Rate
5. Age Specific Mortality Rate 45+
6. Death due to heart diseases
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