Indicators of health.pptx. ...

Indicators of health

1. Dr. Madhu S M INDICATORS OF HEALTH

2. Indicators of health Indicators also termed as Index or Variable is only an indication of a given situation or a reflection of that situation. Health indicator is a variable, susceptible to direct measurement, that reflects the state of health of persons in a community. Indicators help to measure the extent to which the objectives and targets of a programme are being attained.

3. Need for health indicators Health indicators are required to know the health status of a community. It also help us to – To compare health status of one country with that of other. For assessment of health care need. For allocation of scarce resources . For monitoring and evaluation of health services; activities; and programme.

4. Measure different aspect of health of a population. Measures things that influence health. Health status indicator Health determinant indicator Ex : Infant mortality Disability rate Nutritional status Ex : Access to health service Smoking Diet

5. Characteristics of indicators Answers should be same if measured by different people in similar circumstances Valid Reliable Sensitive Specific Feasible Relevant Should actually measure what they are supposed to measure Should be sensitive to changes in the situation concerned Should reflect changes only in the situation concerned Should have the ability to obtain data needed Should contribute to the understanding of the phenomenon of intrest

6. Uses of indicators

7. Classification of indicators Mortality Indicators Morbidity Indicators Disability Rates Nutritional status Indicators Health care delivery indicator Utilization Rates Indicators of social and mental health Environmental Indicators Socio-economic Indicators Health policy Indicators Indicators of quality of life Other Indicators

8. Mortality Indicators Crude Death Rate : No. of death per 1000 population per year in a given community. Crude death rate is 6.9 in India (SRS 2016) Expectation of life : Average no. of years that will be lived by those born alive into a population if the current age specific mortality rates persist.

9. Age specific death rates : It is defined as a total no. of deaths occurring in a specific group of the population in a defined area during a specific period per 1000 estimated population of the same age group of a population in the same area during same period. Infant mortality rate : Infant mortality rate is the ratio of deaths under 1 year to the total number of live births in the same year; usually expressed as a rate per 1000 live birth. IMR is 34.0 in India (SRS 2016)

10. Child death rate : It is defined as the number of deaths at age 1-4yr in a given year, per 1000 children in that age group at the mid-point of the year concerned. Under -5 proportionate mortality rate : It is the proportion of the total deaths occuring in the under -5 age group. Under -5 mortality rate in India is 47.7(2015) Adult mortality rate : It is defined as probability of dying between the age of 15 and 60 years per 1000 population.

11. Utilisation Rates Utilisation rates or actual rates is expressed the proportional of people in need of a service who actually receive it in given period, usually a year. It depends on availability and accessibility of health services and the attitude of an individual towards health care system. They direct attention towards discharge of social responsibility for the organization in delivery of services.

12. Cont…. Examples – Proportion of infants who are fully immunized – 43% (NFHS – 3) Proportion of pregnant women who receive ANC care or have institutional deliveries Percentage of population who adopt family planning Bed occupancy ratio, bed turnover ratio etc.

13. Indicators of Social and Mental Health These includes rates of suicide, homicide, other crime, road traffic accident, juvenile delinquency, alcohol and substance abuse, domestic violence, battered-baby syndrome etc.. These indicators provide a guide to social action for improving the health of people. Social and mental health of the children depend on their parents. Example – Substance abuse in orphan children

14. Environmental Indicators These reflect the quality of physical and biological environment in which diseases occur and people live. The most important are those measuring the proportion of population having access to safe drinking water and sanitation facilities. These indicators explain the prevalence of communicable diseases in a community. The other indicators are those measuring the pollution of air, water radiations, noise pollution, exposure to toxic substances in food and water.

15. Health Policy Indicators The single most important indicator of political commitment is allocation of adequate resources. The relevant indicators are – Proportion of GNP ( gross national product ) spent on health services. Proportion of GNP spent on health related activities like water supply, sanitation, housing and nutrition. Proportion of total health resources devoted to primary health care.

16. Inicators of Quality of Life Life expectancy is now less important. The quality of life has gained importance. Physical Quality of Life Index It consolidates infant mortality, life expectancy at age 1year and literacy. For each component the performance of individual country is placed of 1 to 100. The composite index is calculated by averaging the three indicators giving equa l weight to each of them. The result is placed on the 0 to 100 scale. The PQLI does not consider the GNP.

17. Socio- Economic Indicators These indicators do not directly measure health. Nevertheless, they are of great importance in the interpretation of the indicators of health care. These include – Rate of population increases Per capita GNP Level of unemployment Dependency ratio Literacy rates, especially female literacy rates F amily size Housing – the number of persons per room and Per capita “calorie” availability.

18. Other Indicators Social Indicators population Family formation Families and household learning Earning activities Distribution of income Consumption and accumulation of income Social security Welfare srevices Health services Nutrition Housing and its environment Public order and safety Time use; leisure and culture Social stratification

19. Health for all Indicators : For monitoring progress towards the goal of health for all by 2000AD, the WHO listed the following four categories of indicators. 1) HEALTH POLICY INDICATORS 2)SOCIAL AND ECONOMIC INDICATORS Political commitment to “HEALTH FOR ALL” Rate of population increase Resource allocation GNP and GDP The degree of equity of distribution of health services Income distribution Community involvement Work condition Organisational framework and managerial process Adult literacy rate Housing Food availability

20. Cont… 3) INDICATORS FOR THE PROVISION OF HEALTH CARE 4) HEALTH STATUS INDICATOR Availability Low birth weight Accessibility Infant mortality rate Utilization Child mortality rate Quality of care Life expectancy at birth Maternal mortality rate Disease specific mortality Morbidity – incidence and prevalence

21. Millennium Development Goals – Indicators

22. GOAL 1 : Eradicate extreme poverty and hunger Indicator : Prevalence of underweight children under five of age Proportion of population below minimum level of dietary energy consumption

23. GOAL 4 : Reduce child mortality Indicators – Under 5 mortality rate Infant mortality rate GOAL 5 : Improve maternal health HIV prevalence among young people aged 15 to 24 years Condom use rate of the contraceptive prevalence rate Number of children orphaned by AIDS/HIV Prevalence and death rates associated with malaria. Proportion of population in malaria risk areas using effective malaria prevention and treatment measures. Prevalence and death rates associated with tuberculosis. Proportion of tuberculosis cases detected and cured under DOTS.

24. GOAL 7 :Ensure environmental sustainability Proportion of population using solid fuel. Proportion of population with sustainable access to an improved water source, urban and rural. GOAL 8 : Develop a global partnership for development Proportion of population with access to affordable essential drugs on a sustainable basis.

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