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2. INDICATORS OF HEALTH
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•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 programmeare
being attained.

3. WHAT IS THE 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.
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4. USES OF INDICATORS
Measurement Description Comparisons
Identification of
health needs and
prioritizing them.
Evaluation of
health services
Planning and
allocation of
health resources.
Measurement of
health success
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5. CLASSIFICATION OF INDICATORS
MORTALITY INDICATORS
MORBIDITY INDICATORS
DISABILITY RATES
NUTRITIONAL STATUS INDICATORS
HEALTH CARE DELIVERY INDICATORS
UTILIZATION INDICATORS
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6. CLASSIFICATION OF INDICATORS
INDICATORS OF SOCIAL AND MENTAL HEALTH
ENVIRONMENTAL INDICATORS
SOCIO-ECONOMIC INDICATORS
HEALTH POLICY INDICATORS
INDICATORS OF QUALITY OF LIFE
OTHER INDICATORS
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7. MORTALITY INDICATORS
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•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.

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•Age specific death rates:-It is defined as
total no. of deaths occurring in a specific age
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)

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•Child Death Rate:-It is defined as the number of
deaths at age 1-4 yr 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 occurring 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.

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•Maternal mortality rate:-It is defined as annual
no. of female deaths per 100000 live births from
any cause related to or aggravated by pregnancy
or its management.
MMR in India is 174 (SRS 2015)
•Disease specific mortality rate:-Mortality rates
can be computed for specific diseases.
•Proportion mortality rate:-The simplest measure
of estimating the burden of a disease in the
community is proportional mortality rate,i.e;the
proportion of all deaths currently attributed to it.

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•Case fatality rate:-Case fatality rate is
calculated as number of deaths from a specific
disease during a specific time period divided
by number of cases of the disease during the
same time period, usually expressed as per
100.
Ex:-Case fatality rate of dengue is 0.33%
(2014)

12. MORBIDITY INDICATORS
•Morbidity indicators reveal the burden of ill
health in a community, but do not measure
the subclinical or inapparent disease states.
1)INCIDENCE:
The number of new cases or new events of a
disease in a defined population, within a
specified period of time.
Ex:-The incidence of tuberculosis in India is
167 per 1 lakh population per year (2014)
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13. 2)PREVALENCE:
•The total number of all individuals who have
an attribute or disease at a particular time
divided by population at risk of having
attribute or disease at this point of time.
•Reflects the chronicity of the disease.
•Ex:-The prevalence of tuberculosis in India is
195 per 1 lakhpopulation per year (2014)
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14. 3) NOTIFICATION RATES is calculated from the
reporting to public authorities of certain
diseases.
Ex:-Yellow fever, poliomyelitis
They provide information regarding
geographic clustering of infections, quality of
reporting system etc.
4) ATTENDANCE RATES at OPDs and at health
centers.
5) ADMISSION, READMISSION AND DISCHARGE
RATES.
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15. DISABILITY RATES
Disability rates are of two categories:
EVENT TYPE
INDICATORS
-No. of days of
restricted activity.
-bed disability
days
-work-loss days
within a specified
period.
PERSON TYPE
INDICATORS
-limitation of mobility
Ex-confined to bed
Confined to house
-limitation of activity
Ex-limitation to perfom
the basic activitesof
daily living(ADL).
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16. NUTRITIONAL STATUS INDICATOR
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•Nutritional status is a positive health indicator.
•Newborn are measured for their-
1)Birth weight 2)length 3) head circumference
They reflect the maternal nutritional status.
•Anthropometric measurements of pre-school
children.
1)Weight-measures acute malnutrition
2)Height-measures chronic malnutrition
3)Mid-arm circumference-measures chronic
malnutrition

17. NUTRITIONAL STATUS INDICATOR
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•Underweight: weight for age <-2SD of the
WHO Child Growth Standard median.
•Stunting: height for age < -2SD of the WHO
Child Growth Standard median
•Wasting: weight for height< -2SD of the WHO
Child Growth Standard median
•Overweight: weight for height < -2SD of the
WHO Child Growth Standard median

18. INDICATORS OF SOCIAL AND MENTAL
HEALTH
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•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

19. ENVIRONMENTAL INDICATORS
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•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.

20. HEALTH POLICY INDICATORS
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•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.

21. SOCIO-ECONOMIC INDICATORS
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•These indicators do not directly measure health.
Nevertheless, they are of great importance in the
interpretation of the indicators of health care.
These includes—
1)Rate of population increase
2)Per capita GNP
3) Level of unemployment
4) Dependency ratio
5) Literacy rates, especially female literacy rates
6) Family size
7) housing; the number of persons per room, and
8) Per capita “calorie” availability.

22. OTHER INDICATORS
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•SOCIAL INDICATORS: UN Statistical Office
•POPULATION •WELFARE SERVICES
•FAMILY FORMATION •HEALTH SERVICES
•FAMILIES AND HOUSEHOLD
LEARNING
•NUTRITION
•EARNINGACTIVITES •HOUSING AND ITS ENVIRONMENT
•DISTRIBUTION OF INCOME •PUBLIC ORDER AND SAFETY
•CONSUMPTION AND
ACCUMULATION OF INCOME
•TIME USE; LEISURE AND CULTURE
•SOCIAL SECURITY •SOCIAL STRATIFICATION

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•“HEALTH FOR ALL” INDICATORS:
Formonitoring 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
•Politicalcommitment to “Health For All”•rate of population increase
•Resourceallocation •GNPand GDP
•the degree of equity of distribution of
health services
•Incomedistribution
•community involvement •work condition
•organizational frameworkand managerial
process
•adult literacy rate
•housing
•Food availability

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3) Indicators for the provision
of health care
4) Health status indicators
•availability •low birth weight
•accessibility •infant mortality rate
•utilization •child mortality rate
•quality of care •lifeexpectancy at birth
•maternal mortality rate
•disease specific mortality
•morbidity-incidence and
prevalence

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