HealthIndicators for the national TB program .ppt
- 1. Health Indicators Dr.Esam Mahyoub Community Medicine
- 2. Health Indicators Health indicators are used to measure health of a community Health indicators can be used to compare health of two communities It can be used to assess the health needs of a community It is useful for monitoring and evaluation of health programmes
- 3. Qualities of an ‘indicator’ Validity – The indicator should measure what it is supposed to measure Reliability – It should give the same value when measured by different people Sensitivity – It should show the changes in the situation
- 4. Health indicators Mortality indicators Morbidity indicators Disability rates Nutritional status indicators Health care delivery indicators Socio-economic indicators Indicators of quality of life
- 5. Rates With rates, the numerator is included in the denominator Rate is the number of or frequency of a disease per unit size of population
- 6. Ratios Ratio – the relation in number, degree or quantity existing between two similar things 25 ♀ : 30 ♂
- 7. Proportions Compare like populations or like illnesses within a population For example, 40 children are currently ill with measles, while 80 children all together have or had the measles
- 8. Mortality indicators Crude death rate Specific death rate Case fatality rate Expectation of life Infant mortality rate Maternal mortality rate
- 9. Crude death rate ‘is the number of deaths (from all causes) per 1000 estimated mid-year population in one year, in a given place’ Number of deaths during a year Mid-year population X 1000
- 10. Specific death rate Is the death rate due to a specific disease, or in a specific age or sex group etc. Specific death rate due to Tuberculosis Number of deaths due to Tuberculosis during a year Mid-year population X 1000
- 11. Case fatality rate It is the number of people dying due to a specific disease. It shows the severity of the disease Number of deaths due to a disease Total number of cases due to the disease X 100 %
- 12. Infant Mortality Rate (IMR) Number of infant deaths in a year per 1000 live births Number of deaths of children less than 1 year of age in a year Number of live births in the same year X 1000
- 13. Infant Mortality Infant mortality rates are the most commonly used rates for measuring the risk of dying during the first year of life. Most frequently used measure for comparing health services among nations. Indicator of the level of health in a community
- 14. • Neonatal Mortality Rate (NMR): – Is the number of deaths of infants during their first month (or 4 weeks) per 1000 live births in a certain locality and year. • Post – neonatal Mortality Rate: – Is the number of deaths of infants from one month to one year of age per 1000 live births in a certain locality (or country) and year. • Children 1-4 years Mortality: – It is age specific mortality of preschool children and so called preschool child mortality. It is the number of death of children aged 1-4 years per 1000 children of the same age group in a given locality or country and year 14
- 15. • Perinatal Mortality Rate: – Perinatal period: is the period around labour from 28th week of pregnancy to the end of first week after labour. – Perinatal Mortality Rate: It is the number of death occurring in the perinatal period, after 28th week of pregnancy to the end of first week after labour per 1000 live born in a given locality and year. • Stillbirth Rate: – Stillbirth is a viable fetus delivered after the 28th week of pregnancy without showing any sign of life after being completely expelled from mother. – Stillbirth rate is the number of fetal deaths after the 28th week of pregnancy per 1000 liveborn in a locality and year. 15
- 16. Maternal Mortality Rates There is no system for gathering information for all pregnancies - the closest useful measure is the number of live births. MMR = # deaths in a year from puerperal causes # of live births in the same year Denominator does not include all pregnancies, but number of live births
- 17. Other indicators Birth Rate Fertility Rate
- 18. 1- Birth Rate Crude Birth Rate (CBR): Is the No. of live births per 1000 population of certain locality and year. 18
- 20. Total Fertility Rate: The average number of children that would be born to women surviving until menopause. Birth rate is generally high in developing countries including Yemen, due to: 1- High fertility rates due to social and traditional motives. 2- Poor family planning facilities 3- Factors related to marriage (the youngest age of marriage is associated with long childbearing period). 20
- 21. Measurements of Morbidity Incidence Prevalence
- 22. What is incidence? The incidence is the number of NEW CASES of disease that develop, in a population of individuals at risk, during a specified time period Usually expressed as the number of new cases, per 100,000 population per year
- 23. Example : Measuring incidence Incidence of cervical cancer in a PHC during 2002 Number of new cases during 2002 = 18 Number of disease free persons (‘population at risk’) at the beginning of 2002 = 200,000 Incidence is (18/200,000) x 100,000 9 cases of cervical cancer per 100,000 in 2002 N.B. The denominator might be taken as the population at risk at the beginning, or the mid-point of the year, or the total person-time at risk
- 24. Incidence There are 500 new cases of Hepatitis in a city with a population of 30,000 in 2008 Incidence of hepatitis = The Incidence rate MUST contain the time period 500 30,000 X 1000 = 16.7 per 1000 per year
- 25. What is prevalence? Prevalence is the total number of EXISTING CASES of disease in a population at one point in time.
- 26. Prevalence Prevalence is expressed as a proportion (0-100%) …or as a rate (e.g. X cases per 100,000 population) It does not take into account WHEN people became infected / diseased
- 27. Example : Incidence and prevalence Cases of cold infections in class 4J. Class size: 20 January February March What is the period prevalence during February? What is the incidence in February? 6/20 = 30% 4/?
- 28. Incidence and prevalence Sick population (Prevalence) Healthy population Incidence (new cases) die (mortality) recover
- 29. Summary Health indicators are used for measuring the health status of a community It can also be used to compare health status of two countries or the same country between two time periods There are many mortality and morbidity indicators
- 30. Exercise 30
- 31. Calculate 1. Crude Birth Rate 2. Crude Death Rate 3. Infant Mortality Rate 4. Maternal Mortality Rate 5. Age Specific Mortality Rate 45+ 6. Death due to heart diseases 31