Indicators of Health. To measure the health status of a community. To compare the health status of country with that of another.

1. Indicators of Health
❖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.

2. Indicators of Health
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.
Death Rate Indicator
Disease Indicator
Health Care
Indicator

3. Mortality Indicators
These includes :‐
1. Crude Death Rate
2. Expectation of Life
3. Maternal Mortality Rate
4. Infant Mortality Rate
5. Child Mortality Rate

4. Crude Death Rate :-
1. It can be defined as the Number of death in 1000 population in
a year in a particular area.
2. In 2022, death rate for India was 7.38 per 1,000 people.
Expectation of Life:-
1. It can be defined as the average numbers of years likely to be
lived by a person.
2. If the expectation of life increases, it indicates improvement in
the health status as socio-economic development.
3. To achieve expectation of life at birth, 60 years is the target foe
“Health for All” by 2020.
4. The current life expectancy for India in 2024 is 70.62 years,
a 0.29% increase from 2023.

5. • Maternal mortality refers to deaths due to complications from
pregnancy or childbirth per 100,000.
Maternal Mortality Rate
https://pib.gov.in/FeaturesDeatils.aspx?NoteId=151238&ModuleId%20=%202

6. 50-98% of maternal deaths are
caused by direct obstetric causes
like hemorrhage, infection, and
hypertensive disorders, ruptured
uterus, hepatitis, and anemia.
50% of maternal deaths due to
sepsis are related to illegal induced
abortion.
MMR in India has not declined
significantly in the past 15 years.
The MMR is ‘high’ in Assam
195 per 100,000 live births)..
It is 'low' in Kerala(19
maternal deaths per 100,000
live births).

7. Pradhan Mantri Surakshit Matritva Abhiyan, for instance, seeks to improve
the quality and coverage of diagnostics and counselling services, along with
providing assured comprehensive and quality antenatal care free of cost.

8. Infant Mortality Rate
1. It is the number of infant death out of 1000 live birth in a particular year. Infant
mortality rate is the most widely accepted indicator of health as well as socio-
economic conditions.
2. One important target of “Health for All by 2020” is to bring down the infant
mortality rate 50 per 1000 live birth.
3. The current infant mortality rate for India in 2024 is 25.799 deaths per 1000 live
births, a 3.08% decline from 2023.

9. Child Mortality Rate
• The probability of dying
between birth and exactly five
years of age expressed per
1,000 live births.
• In 2019, child mortality rate
for India was 34.3 deaths per
1,000 live births.

10. Lower respiratory infections (17·9%), (15·6%), diarrhoeal
diseases (9·9%), and birth asphyxia and trauma (8.1%)
were the leading causes of under-5 death in India in 2017.

11. Causes of high child mortality rate in India
1. Lack of access to freshwater.
2. Widespread Illiteracy and Poverty
3. Premature birth and low birth
weight.
4. Poor implementation of govt.
schemes
5. Poor sanitation practices
6. Neonatal infections
7. Birth Asphyxia and Birth Trauma
8. Under-five children are more
prone to communicable diseases.
9. Non-acceptance of girl child in
the society is also a dark cause of
infant mortality.
10.Malnutrition
11. Lack of Adequate Public Health Infrastructure
12. Poor maternal health

12. Morbidity indicators
These indicators give information regarding the disease
situation in the community. Morbidity indicators are
considered more sensitive in comparison to mortality indicator.
The important morbidity indicators are:-
1. Incidence (Total No. of New cases) and Prevalence rate (New + old)
2. OPD attendance rates
3. Hospital admission rates
4. Duration of stay in the hospital
5. Sickness absenteeisms.
6. Notification Rate

13. Disability Indicator
• Disability rates include days of restricted activity, bed disability
days, work loss days, limitation of mobility and limitation of
activity.

14. 1. Event type Indicator:
a) Days of restricted activities.
b) Bed disability days.
c) Work loss days.
2. Person type Indicator:
a) Limitation of mobility: confined to house.
b) Limitation of activity: limitation to perform basic
activities.
Alok Kumar 14
Disability Indicator

15. Nutritional status is a positive health
indicator.
Anthropometric measurement of
pre school children:
1. Weight- measure acute
malnutrition.
2. Hight- measure chronic
malnutrition
3. Mid-arm circumference-
measure chronic malnutrition
Nutritional status indicators

16. a) Hydrocephalus is a condition in which an accumulation of cerebrospinal
fluid (CSF) occurs within the brain.
b) This typically causes increased pressure inside the skull. Older people may
have headaches, double vision, poor balance, urinary incontinence, personality
changes, or mental impairment.
c) In babies, it may be seen as a rapid increase in head size. Other symptoms may
include vomiting, sleepiness, seizures, and downward pointing of the eyes.

17. Infant with huge
hydrocephalus
a) Hydrocephalus is a condition in which
an accumulation of cerebrospinal
fluid (CSF) occurs within the brain.
b) This typically causes increased pressure
inside the skull. Older people may
have headaches, double vision, poor
balance, urinary incontinence,
personality changes, or mental
impairment.
c) In babies, it may be seen as a rapid
increase in head size. Other symptoms
may include vomiting,
sleepiness, seizures, and downward
pointing of the eyes.[1]

18. Mid-arm circumference

19. Healthy care delivery indicators
The indicators reflect the equity of distribution of health resources in
different parts of the country and provision of health care.
➢Doctor -population ratio: 1:834 (Norm 1/1000)
➢Nurse- population ratio: 1.7/1000 (Norm 1/500)
➢Population- bed ratio: 8 beds/10,000 population (Norms1/1000)
➢Population per health center/sub center: 1/5000 in Plain
1/3000 in hilly/tribal/desert
areas
➢Population per traditional health attendant. 20/10000-12000

20. According to Workload
S. No. Bed Strength Number of Pharmacist required
01 Up to 50 beds 03
02 Up to 100 beds 05
03 Up to 200 beds 08
04 Up to 300 beds 10
05 Up to 500 beds 15

21. Utilization rates
Utilization rate indicate the extent to which the health care facilities are utilized
by the population in a year. The important utilization rate are:
a) Proportion of fully immunized infant against six killer diseases of childhood. i.e.
Diphtheria, Tetanus, Neonatorum, Poliomyelitis, Tuberculosis & Measles.
b) Proportion of pregnant women receiving antenatal care of having deliveries
conduct by trained dais.
c) Proportion of population using methods of family planning.
d) Bed occupancy rate
e) Duration of stay in the hospital
f) Bed turn over ratio

22. Indicators of social & mental health
• We have only few indicators which too indirectly reflect the social
and mental health. These are homicide, suicide, other violent
acts, crime, road accident, juvenile delinquency, alcoholism,
drug abuse, smoking, obesity, neglected youth and battered
wife and battered baby syndromes.

23. • Most of these reflect the physical and biological environment of the
human beings. They are related to air & water pollution, solid waste,
radiation, noise, toxic food and drink. The most useful indicators can
be the proportion of population getting safe water supply and proper
sanitation facilities.
Environmental Indicators

24. Socio‐economic indicators
They are purely indirect measures of health status.
They includes rate of population increase, per capita gross national
product (GNP), level of unemployment, family size, dependency
ratio, female literacy rate, number of occupants per room and per
capita available calories.

25. Important Indicator of political commitment in the
form of expenditure on health services.
The important health policy indicators are proportion of GNP
allocated to health services, proportion of GNP on health-
related activities and proportion on resources for primary health.
Healthy policy indicators