Indicators of health

1. INDICATORS OF HEALTH

2.  Indicators also termed as Index orVariable 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.  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. 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
Measurement
Description
Comparisons
Identification 0f
health needs
and prioritizing
them Evaluation of
health services
Planning and
allocation of
health
resources
Measurement
of health sucess

7. 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. 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 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.  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.  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.  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.  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.  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 equal weight to each
of them.
 The result is placed on the 0 to 100 scale.
 The PQLI does not consider the GNP.

17.  These indicators do not directly measure health.
Nevertheless, they are of great importance in the
interpretation of the indicators of health care.
 These include –
1) Rate of population increases
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.

18. 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. 3) INDICATORS FORTHE 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
Millennium
developmental
Goals
Eradicate
extreme poverty
and hunger
Achieve
universal
primary
education
Promote gender
equality and
empower
women
Reduce child
mortality
Improve
maternal health
Combat
HIV/AIDS,
malaria and
other diseases
Ensure
environmental
sustainability
Global
partnership for
development

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.

25. THANKYOU