Choosing Health Indicators

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Choosing Health Indicators
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Health, Income and Poverty

• 70 of the variance in infant mortality can be
  attributed to across and within country
  differences in income
• Half of the burden of communicable diseases is
  concentrated in the
• Lowest income quintile (poorest 20)
• Globally the poorest 20 experience three and a
  half the mortality and four times the number of
  Disability Adjusted Life-Years (DALYs) loss of
  the richest 20, an equivalent to excess
  mortality of nearly 10,000, 000 deaths per year
• Communicable diseases are responsible for 60 of
  both deaths and DALYs loss in the poorest groups.

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Predictive Indicators
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Key Indicators for Assessing Poverty
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Key Performance Indicators

• Structural- buildings, equipment, supplies,
  vehicles
• Process- prevention, diagnosis, numbers trained,
• Outcome- five Ds- death, diseases, disability,
  dissatisfaction, discomfort

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Structural Indicators

• Household characteristics household size,
  number of rooms
• Pharmacy supplies of specific categories of
  drugs, e.g., anti-malarials
• Numbers of latrines,
• Number of stem pipes, boreholes

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Process Indicators

• Changes in access times for secure water
  supplies
• Access to maternal medical services such as
  trained birth attendants, and number of
  pre-delivery visits
• In migration patterns place of origin of
  household members, professional status of
  household members
• Training with follow-up knowledge attitudes
  practices beliefs (KABP) around prevailing
  diseases

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Outcome Indicators

• Disease specific prevalence rates
• Anemia prevalence
• Anthropometric measurements of young children
• Alcohol use, smoking rates, domestic violence and
  accidents
• Toxicology biomonitoring (lead, arsenic, etc.)
  if relevant
• Increase in prevalent disease
• Appearance of new disease

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Key Performance Indicators
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Key Performance Indicators (KPIs)

• KPIs
• Typically track changes in the level of a
  variable over time, i.e., rates
• Objectively demonstrating rate changes, positive
  or negative, is surprisingly complex
• Small community population sizes can mean big
  statistical analysis problems, e.g., infant and
  maternal mortality
• Underlying community disease rates naturally
  fluctuate over time and space, e.g., malaria
• For high profile complex projects a formal
  Demographic Surveillance System (DSS) is a
  cost-effective, capacity building and sustainable
  strategy