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Dr. Malik Muhammad Abdul Razzaq Assistant Professor Department of Community Medicine Sheikh Zayed Medical College Rahim Yar Khan. Community Medicine A system of delivery of comprehensive health care to the people by a health team in order to improve the health of the community.
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Dr. Malik Muhammad Abdul Razzaq Assistant Professor • Department of Community Medicine • Sheikh Zayed Medical College • Rahim Yar Khan Dr. Malik Muhammad Abdul Razzaq
Community Medicine A system of delivery of comprehensive health care to the people by a health team in order to improve the health of the community Dr. Malik Muhammad Abdul Razzaq
. Dr. Malik Muhammad Abdul Razzaq
Health Indicators • To measure Health status of a Community / country • Comparison of health status between two communities/Countries. • Assessment of health care needs • Allocation of scare resources • Monitoring & Evaluation of health services, activities & programmes. • The extent to which the objectives & targets are being attained. Dr. Malik Muhammad Abdul Razzaq
Indicator: Indicators are an indication of a given situation or a reflection of a situation. Variable: A characteristic of interest in a study that has different values for different objects and subjects. - which helps to measure changes - These can indicate direction and speed of change - Serve to compare different areas or groups of people at the same time. Dr. Malik Muhammad Abdul Razzaq
Characteristics of an indicator:- i. Valid ii. Reliable iii. Sensitive iv. Specific v . feasible vi. Relevant. Dr. Malik Muhammad Abdul Razzaq
Health Indicators • Mortality indicators • Morbidity indicators • Disability rates • Nutritional status indicators • Health care delivery indicators • utilization rates • Indicators of social and mental health • Environmental indicators • Socio-economic indicators • Health policy Indicators • Indicators of quality of life • other indictors Dr. Malik Muhammad Abdul Razzaq
Mortality Indicators • Crude death rate (CDR) • Expectation of life • Infant mortality rate (IMR) • Child mortality rate (CMR) • Under -5 Mortality rate (U5MR) • Maternal mortality rate (MMR) • Disease specific mortality rate (DSMR) • Proportional mortality rate Dr. Malik Muhammad Abdul Razzaq
Morbidity Indicators • Incidence and Prevalence • Notification rates • Attendance rates at out-patient departments, health centers, etc. • Admission, readmission and discharge rates • Duration of stay in hospital and • Spells of sickness • Absence from work or school. Dr. Malik Muhammad Abdul Razzaq
Disability Indicators a) Event-type indicators: i) Number of days of restricted activity ii) Bed disability days iii) Work-loss days iv) School loss days within a specified period b) Person-type indicators: i) Limitation of mobility ii) Limitation of activity Dr. Malik Muhammad Abdul Razzaq
Nutritional Status Indicators • Anthropometric measurements of preschool children, e.g., weight and height, mid-arm circumference; b) Heights (and sometimes weights ) of children at school entry; and c) Prevalence of low birth weight – LBW (less than 2.5 kg). Dr. Malik Muhammad Abdul Razzaq
Health Care Delivery indicators a) Doctor-population ratio b) Doctor-nurse ratio c) Population –bed ratio d) Population per health center /subcentre e) Population per traditional birth attendant f ) Availability of health services g) Accessibility of health care services h) Utilization I ) Quality of health care delivery Dr. Malik Muhammad Abdul Razzaq
Utilization rates • Proportion of infants who are “fully immunized” against the 7 EPI diseases. • Proportion of pregnant women who receive antenatal care, or have their deliveries supervised by a trained birth attendant. • Percentage of the population using various methods of family planning. • Bed-occupancy rate (i.e., average daily in-patient /average number of beds). • Average length of stay (i.e., days of care rendered / discharges). • Bed turn-over ratio (i.e., discharges/average beds). Dr. Malik Muhammad Abdul Razzaq
Socio-economic indicators • Rate of population increase • Per capita GNP • Level of unemployment • Dependency ratio • Literacy rates, especially female literacy rate • Family size. • Housing: the number of persons per room • Per capita “calorie” availability • Working conditions • Income distribution Dr. Malik Muhammad Abdul Razzaq
SOCIAL INDICATORS 1.POPULATION 2.FAMILY FORMATION & HOUSEHOLD 3.EDUCATIONAL OPPORTUNITIES 4.EARNING ACTIVITIES 5.SOCIAL SECURITY & FAMILY WELFARE 6.HEALTH SERVICES 7.NUTRITION 8.INCOME DISTRIBUTION 9.ENVIRONMENT 10. PUBLIC ORDER & SAFETY 11.TIME USE AND LEISURE, RECREATION 12.SOCIAL STRATIFICATION AND MOBILITY Dr. Malik Muhammad Abdul Razzaq
Selected health and socio-economic indicators Dr. Malik Muhammad Abdul Razzaq
Health Policy Indicators • Political commitment to health for all • Resource allocation, GNP spent • Degree of equity distribution of health services. • Community Involvement • Organization frame work • Managerial Process. Dr. Malik Muhammad Abdul Razzaq
MILLENNIUM DEVELOPMENT GOAL INDICATORS • Eradicate extreme poverty and hunger • Reduce Child Mortality • Improve Maternal Health • Combat HIV/AIDS, malaria and other diseases • Ensure environmental sustainability • Develop a global partnership for development Dr. Malik Muhammad Abdul Razzaq
Comparison of Kerala and all-India Health Statistics Dr. Malik Muhammad Abdul Razzaq