Indicators of Health

Indicators of Health
Facilitator:
Dr. NAVPREET
Assistant Professor, Department of Community Medicine
Govt. Medical College & Hospital, Chandigarh.
Specific Learning Objectives
• At the end of session, the learner shall be able to:
 Describe Indicators of health
 Compare health in Developed and Developing
countries
 Understand Health service philosophies
• To measure the health status of a community
• To compare the health status of country with that of
another.
• Characteristics of indicators:
 Should be valid
 Should be reliable & objective
 Should be sensitive
 Should be specific
 Should be feasible
 Should be relevant.
1. Mortality indicators
2. Morbidity indicators
3. Disability rates
4. Nutritional status indicators
5. Healthy care delivery indicators
6. Utilization rates
7. Indicators of social & mental health
8. Environmental indicators
9. Socio‐economic indicators
10. Healthy policy indicators
11. Indicators of quality of life.
12. Other indicators.
Mortality Indicators
These includes :‐
• Crude Death Rate
• Expectation of Life
• Maternal Mortality Rate
• Infant Mortality Rate
• Child Mortality Rate
• Under 5 proportionate mortality rate
• Disease Specific Mortality
• Proportional Mortality Rate
Morbidity Indicators
• Used to supplement mortality data.
• Morbidity rates used for assessing ill health in
community are:
Incidence
Prevalence
Notification rate
Attendance rate at OPDs, health centres etc.
Admission, readmission and discharge rates
Spells of sickness.
Disability Rates
• Based on premises or portion that health implies a
full range of daily activities.
• Two groups:
 Event type indicators:
– Number of days of restricted activity
– Bed disability days
– Work‐loss days within a specified period
 Person‐type indicators:
– Limitation of mobility
– Limitation of activity (ADL)
• Sullivan’s Index
– Expectation of life free of disability
• HALE (Health Adjusted Life Expectancy)
– The equivalent number of years in full health that a
newborn can expect to live based on current rates of
ill‐health and mortality.
• DALY (Disability Adjusted Life Year)
– Number of years lost due to ill‐health, disability or ill‐
health.
• QALY (Quality adjusted life year)
– Number of years of life that would be added by a
medical intervention.
Nutritional Status Indicators
It includes :‐
• Anthropometric measurement of pre‐ school
children.
• Height of children at school entry.
• Prevalence of low birth weight.
Health Care Delivery Indicators
It includes :‐
• Doctor : population ratio
• Doctor : nurse ratio
• Population : bed ratio
Utilization Rate
• Expressed as proportion of people in need of
health care services who actually receive it in
a given period.
– Proportion of infants who are fully immunized
against the Seven EPI diseases.
– Percentage of population using the various
methods of family planning.
Indicators of Social & Mental Health
• Indirect measures
• It includes indicators of social pathology:‐
Suicide
Homicide
Other acts of violence
Other crime etc.
Alcohol and drug abuse, etc.
Environmental Indicators
• Reflects quality of physical & biological
environment.
– Proportion of population having access to safe
water
– Proportion of population having access to sanitation
facilities
– Indicators relating to pollution of air and water,
radiation, solid wastes, noise
Socio Economic Indicators
It Includes :‐
• Rate of population decrease
• Per capita GNP
• Level of unemployment
• Dependency ratio etc.
Health Policy Indicators
• Important Indicator of political commitment
• “Allocation of adequate resources”
– Proportion of GNP spent upon health services
– Proportion of GNP spent upon health‐related
activities
– Proportion of total health resources devoted to
primary health care.
Other Indicators
It Includes :‐
• Social Indicators
• Basic Need Indicators
• Health For All Indicators
• Millennium Development Goal Indicators
• There is no single comprehensive indicator of
nation’s health.
• Each of the available indicators reflects an
aspect of health.
Developed and Developing Regions
• Social and economic characteristics
• Demographic characteristics
• Contrast in health (Health Gap)
Social and economic characteristics
Variable Developing Developed
Countries Countries
Place of residence Mostly Rural Mostly Urban
Major occupation Agriculture Industry
Standard of living Low High
GNP per capita 200 to 6,000 US $ 5,000 to 40,600 US $
Adult literacy Low High
Women Economically Economically

dependent independent
Demographic characteristics
Variable Developing Developed

Countries Countries
Growth Rate Above global GR Below global GR
(>1.3%) (<1.3%)
Young population 28% ‐ 38% 18%
Elder population 6% 21%
Contrast in health (Health Gap)
Health care
• Multitude of services
– rendered to individuals, families or communities
– by the agents of the health service or professions,
– for the purpose of promoting, maintaining,
monitoring or restoring health.
Characteristics of Health Care
• Appropriateness (relevance)
• Comprehensiveness
• Adequacy
• Availability
• Accessibility
• Affordability
• Feasibility
Levels of Health Care
• Primary health care
• Secondary health care
• Tertiary health care
Primary health care
• First level of contact between individual and health
system
• Majority of prevailing health complaints and
problems can be satisfactorily dealt with
• Primary health centres, Sub centres, Community
participation
Secondary health care
• Essentially curative services
• First referral level
• Community health centres & District hospitals
Tertiary health care
• Super‐specialist care,
• Planning and managerial skills,
• Teaching for specialized staff.
• Regional and central level institutions.
Health Team Concept
• Professionals
• Auxiliary worker
• Team comprising of physicians, nurses, social
workers, health assistants, trained dais, village
health guides etc.
THANKS.
• Health for All (HFA)
• Health Promotion
• Millennium Development Goals (MDGs)

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Indicators of Health

Major occupation Agriculture Industry

Standard of living Low High

GNP per capita 200 to 6,000 US $ 5,000 to 40,600 US $

Adult literacy Low High

Women Economically Economically

Variable Developing Developed

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