3. Vital statistics:-
Introduction:
Vital Statistics considered as indicators of health.
Important vital statistics are birth rate and death
rate.Mother and Child status is assessed through
measurement of Mortality and Morbidity.
Registration of vital events.(WHO 1981-Health for
all,sr,No 4)
India had Vital event Registration Act since 1873-
voluntary registration
In 1970 the act came into force – Compulsory
Time limit for Births-14th days Deaths- 7days
4. COMMONLY USED
INDICATORS OF MCH CARE
1) Maternal morbidity rate
2)Maternal motality rate
3)Fertility rates
4)Mortality in infancy and childhood
Perinatal mortality rate
Neonatal mortality rate
Post neonatal mortality rate
Infant mortality rate
5. MATERNAL MORBIDITY:-
Definition:-
Maternal morbidity originates from any
cause related to pregnancy or its
managements any time from ante partum,
intrapartum , and postpartum period usually
up to 42 days after childbirth.
6. Classification of Maternal
Morbidity
MATERNAL MORBIDITY
DIRECT
TEMPORARY PERMANENT
INDIRECT
APH,PPH,Eclampsia,obstruct
ed labour,rupture
uterus,sepsis,ectopic
pregnancy
Sheehan’s
syndrome,infertility.
7. MATERNAL MORTALITY
❖ Maternal death is defined as “the death of
woman while pregnant or within 42 days of
termination of pregnancy ,irrespective of the
duration and site of pregnancy from any cause
related to or aggravated by the pregnancy or
its management but not from accidental or
incidental causes.
- According toWHO
8. ACCORDING TO ICD MATERNAL
DEATH DIVIDED INTO TWO GROUP
MATERNAL
MORTALITY
LATE
MATERNAL
DEATH
DIRECT
INDIRECT
PREGNANCY
RELATED DEATH
9. CAUSES OF MATERNAL
MORBIDITY AND
MORTALITY
❖OBSTETRIC
Toxemia of pregnancy
Haemorrage
Infection
Obstructed
Unsafe abortion
❖Non obstetric:
Anaemia
Associated disease.e.g.
cardiac,renal,hepatic,infe
ctious and metabolic
Malignancy
Accidents
10. ❖SOCIAL FACTORS
Age at child birth
Parity
Too close pregnancies
Family size
Malnutrition
Poverty
Illiteracy
Ignorance and prejudices
Lack of maternity services
Shortage of health manpower
Delivery by untrained dais.
Poor environmental sanitation
Poor communication and transport facilities
11.
12.
13.
14. Integration of domiciliary ,rural and institutional services
with efficient referral system .
Promotion of family planning services.
Clean delivery practices.
Identification of every maternal death and searching for
the cases.
Maternal mortality conferences with frank discussion
regarding the cases of death and to find whether it was
avoidable .Annual reports of such enquiry committees are
to be published for necessary preventive measures.
Periodic refresher courses for continuing of general
practitioner ,obstetricians,midwives and auxillary staff to
highlight the preventable factors.
Newer approaches such as ‘risk approach’ and primary
health care are the steps in the right direction to reduce
maternal mortality and morbidity.
15.
16. FERTILITY RATES:
Women reproductive period is roughly from
15-45 years (a period of 30 years) Fertility
depends upon several factors .The higher
fertility in India is attributed to lower age of
marriage ,low level literacy ,poor level of
living ,limited use of contraceptives
,traditional way of life.
17. Fertility may be measured by a
number of indicators as given below,
BIRTH
RATE
GENERAL
FERTILITY
RATE
TOTAL
FERTILITY
RATE
AGE
SPECIFIC
FERTILITY
RATE
GROSS
REPRODU
CTIVE
RATE
NET
REPRODUC
TIVE RATE
GENERAL
MARITAL
FERTILITY
RATE
AGE
SPECIFIC
MARITAL
FERTILITY
RATE
TOTAL
MARITAL
FERTILITY
RATE
19. Perinatal Mortality Rate:-
Perinatal mortality is defined among foetus
weighing over 1000gms at birth who die before
and during delivery or within the first 7 days of
delivery.The Perinatal mortality rate is
expressed in term of such deaths per 1000
total birth.
20.
21. CAUSES OF PERINATAL
MORTALITY
ANTENATAL
CAUSES
Maternal disease
Pelvic diseases
Anatomical defects
Endocrine
imbalance and
inadequate uterine
preparation.
Blood
incompatability
Mal nutrition
Toxaemia of
pregnancy
Ante partum
haemarrohage
Congenital defects
24. Proper care and good organizational set up.
Pre Pregnancy Health care counselling
Regular Antenatal care.
Improvement of maternal nutrition
Detection and correction of anemia and
prevention of eclampsia and preeclampsia
Screening of high risk patients.
Careful monitoring in labour and avoidance of
traumatic delivery.
Trained birth attendant to be available
practicing 7 cleans of delivery-clean hand,clean
surface, clean cloth, clean blabe,clean cord
tie,clean stem,and clean warm water.
25. Providing efficient neonatal paediatric
services.
Educating the public about family planning
services.
Essential new born care.
Autopsy studies of perinatal death.
Continued studies of perinatal mortality
problems by demographic stidies,regular
clinical and interdepartmental meetings and
pathological research.
26. Still Birth:
A still birth is a birth of a newborn after 28th
completed week (weighing 1000gm or more)
when the baby does not breath or show any
sign of life after delivery such death include
ante partum deaths (macerated) and intra
partum deaths (fresh still birth ).still birth rate
is the number of such deaths per 1000 total
births(live and still)
28. Neonatal Mortality Rate:
Neonatal death are deaths occurring during
the neonatal period commencing at birth and
ending 28 completed days after birth. Neonatal
mortality rate is the number of neonatal deaths in
a given year per 1000 live births in that year
Number of deaths of children under
28 days of age in a year
= × 1000
Total number of live birth in the
same year
29.
30. Post-neonatal Mortality Rate:
Number of deaths of children
between28 Days and oneYear of age in a
given year
= ×1000
Total live births in the same year
31. Causes of post neonatal
mortality:
Diarrhoeal disease
Acute respiratory infections
Other communicable disease
Malnutrition
Congenital anomalies
Accidents
32. Infant Mortality Rate
Number of deaths of children
Less than 1 year of age in a year
= ×1000
Number of live births in the
same year
33. CAUSES OF INFANT MORTALITY
Low birth weight
Post natal asphyxia.
Birth injuries and difficulty labour
Congenital anomalies
Haemolytic disease of new born
Condition of placenta and cord
Diarrhoeal disease
Acute respiratory infections
Tetanus
Other communicable disaease
Malnutrition
Congenital anomalies
Accidents
35. BIOLOGICAL FACTORS
Birth weight
Age of the mother
Birth order
Birth spacing
Multiple births
Family size
36. Cultural and social factors:
Breast feeding
Rligious and caste
Early marriage
Sex of the child
Quality of mothering
Maternal education
Quality of health care
Illegitimacy
The indigenous dais
37. Preventive And Social Measures
Perinatal Nutrition
Prevention of infection
Breast feeding
Growth monitoring
Family Planning
Sanitation
Provision of Primary health care,
Socio economic development
Education
38.
39. SUMMARY
1) What is vital stastics ?
2) Which indicators are included in vital satastics?
3) Definition
4) Causes
5) Prevention