1. PRESENTED BY:
POOJA SANALKUMAR

2. HEALTH INDICATOR is a variable, susceptible
to direct measurement, that reflects the
state of health of the subjects in a
community

3.  VALID
 RELIABLE
 SENSITIVE
 SPECFIC
 FEASIBLE
 RELEVANT

4.  Measurement, Description and Comparison of
the health of the community.
 Identification of health needs & prioritizing
them.
 Planning & allocation of health resources.
 Measurement of health successes.

5. Mortality indicators Indicators of social and
mental health
Morbidity indicators Environmental indicators
Disability rates Socio-economic indicators
Nutritional indicators Health policy indicators
Health care delivery
indicators
Indicators of quality of life
Utilization rates Other indicators

6.  Crude Death Rate
 Expectation Of Life
 Age Specific Death Rate
 Infant Mortality Rate
 Child Mortality Rate
 Under 5 Proportionate Mortality Rate
 Adult Mortality Rate
 Maternal Mortality Rate
 Disease Specific Mortality Rate
 Proportional Mortality Rate
 Case Fatality Rate
 Years Of Potential Life Lost

7.  Number of deaths per 1000 population per
year in a given community.
 Fair indicator of health.
 ↓ death rate – assesses health improvement
in a community the overall.

8.  Life expectancy at birth : the average number
of years that will be lived by those born alive
into a population if the current age-specific
mortality rates persist.
 In India,
◦ Male 63.8
◦ female 67.3

9. 65
80
67
76
68
86
69
81
0
20
40
60
80
100
INDIA JAPAN NEPAL USA
Males Females
Source – K.Park, Fertility, Park’s Textbook of
social and preventive medicine, 2015, 23rd
Edition, M/s Banarsidas Bhanot, India

10. 58 60 66.2 67.2 74 69
0
20
40
60
80
Life Expectancy
Source:
http://populationcommission.nic.in
/content/932_1_TablesMapsAndBar
Charts.aspx , accessed on June 2nd
2015

11.  The ratio of deaths of children under 1 year
of age in a given year to the total number of
live births, in the same year.
 Usually expressed as rate per 1000 live
births.
 Sensitive indicator of availability,
utilisation and effectiveness of
health care, particularly
perinatal care.

12. 54%
16%
4%
4%
2%
3%
17%
Low Birth Weight
Respiratory infections
diarrhoeal disease
congenital
malformations
cord infection
birth injury
unclassified
IN INDIA

13. India Sri Lanka Bangladesh Pakistan US China
1990 88 18 100 106 9 42
2013 41 8 33 69 6 11
0
20
40
60
80
100
120

14. Assam Karnataka Punjab Delhi Kerala
RURAL 58 36 30 36 13
URBAN 33 25 24 23 9
COMBINED 55 32 29 25 12
0
10
20
30
40
50
60
70
Infant Mortality Rates

15.  Improved obstetric and perinatal care
(availabity of oxygen, foetal monitoring
during labour)
 Improvement in quality of life(social and
economic progress)
 Better control of communicable
diseases(immunisation)
 Better nutrition(emphasis on
breast feeding)
 Family planning(birth spacing)

16.  Number of deaths at age of 1-4 years in a
given year, per 1000 children in that age
group at the mid-point of the year.
 Correlates with inadequate MCH services, low
coverage by immunisation & adverse
environmental exposure.

17.  The proportion of total deaths occurring in
the under-5 age group.
 Reflects both infant and child mortality.
 In India, 59/1000
 In China, 18/1000

18.  Number of maternal deaths in a given period
per 100,00 women of reproductive age
during the same time period.
 Accounts for the greatest proportion of
deaths among women of
reproductive age in most
developing countries.

19. 8%
5%
5%
11%
37%
34%
IN INDIA
Abortion
Obstructed labour
Hypersensitive
disorders
Sepsis
Haemorrhage

20. 28 32
170 178
200
0
50
100
150
200
250
US China Pakistan India Myanmar
Maternal Mortality Rate

21. 21.1
8.1 9 3.3
230
144
155
66
0
50
100
150
200
250
MP Karnataka Punjab Kerala
Maternal Mortality Rate/100,00 births
Maternal Mortality Ratio

22.  Estimates the burden of a disease in a
community.
 Example, Coronary heart disease – 25 to 35%
of all deaths in western countries.
 Other Mortality indicators are case fatality
rate and Years Of Potential Life Lost(YPLL).

23.  Extrication of communicable diseases
 Other indicators emerged, like in deaths from
cancers, cardiovascular diseases, accidents,
diabetes, etc.

24.  Incomplete reporting of deaths
 Lack of accuracy (recording age and cause of
death)
 Lack of uniformity and standardised method
of data collection.

25.  Any departure, subjective or objective, from a state
of physiological well being.
 Used to supplement
mortality data to describe
the health status of a
population

26.  Following morbidity rates are used:
◦ Incidence and prevalence
◦ Notification rates
◦ Attendance rate at the O/P dept.
◦ Admission, readmission & discharge dates
◦ Duration of stay in hospital
◦ Spells of sickness/absence from work/school.

27.  Disability is defined as “any restriction or lack
of ability to perform an activity in a manner
or within the range considered normal for a
human being.”
 Types :
(1)Event type indicators
(2)Person type indicators

28. Event-type indicators
Person-type
indicators
 Number of days of
restricted activity
 Bed disability days
 Work-loss days
within a specific
period
 Limitation of
mobility (confined
to bed/ house)
 Limitation of
activity

29.  Based on life expectancy at birth and includes
an adjustment for time spent in poor health.
 It is the equivalent number of years in full
health a new born can expect to live based on
current rates of ill health and mortality.

30.  Used for assessing value for money of
medical intervention
 Values : perfect health = 1.0
death = 0.0
Therefore, 1 QALY=1 year of life x 1 unity
value.

31.  Measure of overall disease burden, expressed
in number of years lost due to ill health or
early death.
 Daly combines: Years of Lost Life (YLL) and
Years Lost to Disability (YDL)
 DALY= YLL + YLD

33.  3 Nutritional Status indicators considered
important are:
◦ Prevalence of low birth weight (2.5 kg)
◦ Height and weight of children at school entry
◦ Anthropometric Measurement of preschool children

34.  Reflects the equity of distribution of health
resources in different parts of the country, and of
provision of health care.
 Frequently used indicators:
◦ Doctor-population ratio
◦ Doctor-nurse ratio
◦ Population-bed ratio
◦ Population per health/sub centre
◦ Population per traditional birth attendant