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Health IndicatorsHealth Indicators Mortality indicatorsMortality indicators Morbidity indicatorsMorbidity indicators Disability ratesDisability rates Nutritional status indicatorsNutritional status indicators Health care delivery indicatorsHealth care delivery indicators utilization ratesutilization rates Indicators of social and mental healthIndicators of social and mental health Environmental indicatorsEnvironmental indicators Socio-economic indicatorsSocio-economic indicators Health policy IndicatorsHealth policy Indicators Indicators of quality of lifeIndicators of quality of life other indictorsother indictors

Utilization ratesUtilization rates Proportion of infants who are “fully Proportion of infants who are “fully

Immunized” against the 7 EPI diseases.Immunized” against the 7 EPI diseases. Proportion of pregnant women who receive Proportion of pregnant women who receive

antenatal care, or have their deliveries antenatal care, or have their deliveries supervised by a trained birth attendant.supervised by a trained birth attendant.

Percentage of the population using various Percentage of the population using various methods of family planning.methods of family planning.

Bed-occupancy rate (i.e., average daily in-Bed-occupancy rate (i.e., average daily in-patient /average number of beds).patient /average number of beds).

Average length of stay (i.e., days of care Average length of stay (i.e., days of care rendered / discharges).rendered / discharges).

Bed turn-over ratio (i.e., discharges/average Bed turn-over ratio (i.e., discharges/average beds).beds).

Socio-economic indicatorsSocio-economic indicators Rate of population increaseRate of population increase Per capita GNPPer capita GNP Level of unemployment Level of unemployment Dependency ratioDependency ratio Literacy rates, especially female literacy rateLiteracy rates, especially female literacy rate Family size.Family size. Housing: the number of persons per roomHousing: the number of persons per room Per capita “calorie” availabilityPer capita “calorie” availability Working conditionsWorking conditions Income distributionIncome distribution

POPULATION OF PAKISTAN (MILLIONS)

28.28233.817

42.978

65.341

84.254

113.78

130.58

154.794

0

20

40

60

80

100

120

140

160

180

1941 1951 1961 1972 1981 1991 1998 2006

YEAR

POP.

IN M

ILLI

ONS

POPULOUS COUNTRIES OF WORLD

1, 298

1, 065

293238

184 159 143 141

0

200

400

600

800

1, 000

1, 200

1, 400

CHI NA I NDI A USA I NDONESI A BRAZI L PAKI STAN RUSSI A BANGLA DESH

NAME OF COUNTRY

SOCIAL INDICATORSSOCIAL INDICATORS1.POPULATION2.FAMILY FORMATION & HOUSEHOLD3.EDUCATIONAL OPPORTUNITIES4.EARNING ACTIVITIES5.SOCIAL SECURITY & FAMILY WELFARE6.HEALTH SERVICES7.NUTRITION 8.INCOME DISTRIBUTION9.ENVIRONMENT 10. PUBLIC ORDER &

SAFETY11.TIME USE AND LEISURE, RECREATION12.SOCIAL STRATIFICATION AND MOBILITY

Health Policy IndicatorsHealth Policy Indicators

Political commitment to health Political commitment to health for allfor all

Resource allocation, GNP spentResource allocation, GNP spent Degree of equity distribution of Degree of equity distribution of

health services.health services. Community InvolvementCommunity Involvement Organization frame workOrganization frame work Managerial Process.Managerial Process.

MILLENNIUM DEVELOPMENT MILLENNIUM DEVELOPMENT GOAL INDICATORSGOAL INDICATORS

Eradicate extreme poverty and hungerEradicate extreme poverty and hunger Improve Maternal Health & reduce child Improve Maternal Health & reduce child

MortalityMortality Combat HIV/AIDS, malaria and other Combat HIV/AIDS, malaria and other

diseasesdiseases Achieve Universal Primary EducationAchieve Universal Primary Education Ensure environmental sustainabilityEnsure environmental sustainability Develop a global partnership for Develop a global partnership for

development development

Comparison of Kerala and all-India Health StatisticsComparison of Kerala and all-India Health Statistics

KeralaKerala All-IndiaAll-IndiaDeath rate/1000(2002)Death rate/1000(2002) 6.46.4 8.18.1Rural birth rate(2002)Rural birth rate(2002) 16.816.8 25.025.0Infant mortality rate Infant mortality rate (2002)(2002)

1010 6464

Annual growth rate, per Annual growth rate, per cent (2001)cent (2001)

0.90.9 1.931.93

Life expectancy at birth Life expectancy at birth 2001-06 (Projection)2001-06 (Projection)

MaleMale

FemaleFemale

66.566.5

71.771.7

7575

61.561.5

64.164.1

65.465.4

Literacy rate, Literacy rate, percent(2001)percent(2001)

90.9290.92 65.3865.38

Female literacy rate (2001)Female literacy rate (2001) 87.8687.86 54.1654.16

Mean age at marriage Mean age at marriage females (1999)females (1999)

22.122.1 19.519.5

Per capita income (2000-1)Per capita income (2000-1) Rs. 21046Rs. 21046 Rs. 16707Rs. 16707

Doctor-population ratio Doctor-population ratio (1991)(1991)

1: 72131: 7213 1:21481:2148

Health CareHealth Care““Multitude of services Multitude of services

rendered to individuals, rendered to individuals, families or communities by families or communities by

the agents of the health the agents of the health services or professions, for services or professions, for the purpose of promoting, the purpose of promoting, maintaining, monitoring or maintaining, monitoring or

restoring health.”restoring health.”

Characteristics of Health CareCharacteristics of Health Care

1. Appropriateness1. Appropriateness

2. Comprehensiveness2. Comprehensiveness

3. Adequacy3. Adequacy 4. Availability 4. Availability

5. Accessibility 6.Affordability5. Accessibility 6.Affordability

7. Feasibility7. Feasibility

INFANT MORTALITY RATES

191. 19

163. 07

100. 44

72. 44

56. 29

41. 58

24. 18 17. 79. 95 8. 51 6. 5 5. 53 5. 16 4. 69 3. 7 3. 26 2. 29

0

50

100

150

200

250

Angola Pakistan China Hungry UK J apan

COUNTRY

IMR PAKISTAN

82. 49

80. 5

78. 52

76. 53

74. 53

72. 5

66

68

70

72

74

76

78

80

82

84

Y-2000 Y-2001 Y-2002 Y-2003 Y-2004 Y-2005

YEAR

PRIMARY HEALTH CAREPRIMARY HEALTH CARE

“ “Primary Health care is essential health Primary Health care is essential health care based on scientifically sound and care based on scientifically sound and

socially acceptable methods and socially acceptable methods and technology, made universally accessible technology, made universally accessible

to individuals and families in the to individuals and families in the community through their full participation community through their full participation

and at a cost that that a country and and at a cost that that a country and community can afford to maintain in community can afford to maintain in

every stage of development in the sirit of every stage of development in the sirit of self-reliance and self-reliance and self-self-reliance and self-reliance and self-

determination:determination:

COMPONENTS OR ELEMENTSCOMPONENTS OR ELEMENTS Education concerning prevailing health problems Education concerning prevailing health problems

and the methods of controlling and preventing and the methods of controlling and preventing them.them.

Promotion of food supply and proper nutrition. Promotion of food supply and proper nutrition. An adequate supply of safe water and basic An adequate supply of safe water and basic

sanitation.sanitation. Maternal and child health care including family Maternal and child health care including family

planning.planning. Immunization against major infectious diseases.Immunization against major infectious diseases. Prevention and control of locally endemic Prevention and control of locally endemic

diseases.diseases. Appropriate treatment of common diseases and Appropriate treatment of common diseases and

injuries.injuries. Provision of essential drugs.Provision of essential drugs.

Key Concepts of Primary Health CareKey Concepts of Primary Health Care

EQUITY:EQUITY: Equity means everyone is Equity means everyone is entitled to receive care and that care entitled to receive care and that care should be according to need.should be according to need.

EFFECTIVENESS:EFFECTIVENESS: Each primary health Each primary health care activity should have a favorable care activity should have a favorable effect be according to need.effect be according to need.

EFFICIENCY:EFFICIENCY: Primary health care Primary health care programs should be low-cost and programs should be low-cost and affordable.affordable.

Health related Millennium Health related Millennium Development Goals and indicatorsDevelopment Goals and indicators

Goal:1/1Goal:1/1 Eradicate extreme poverty and Eradicate extreme poverty and hungerhunger

Goal : 2/4Goal : 2/4 Reduce child mortalityReduce child mortality Goal : 3/5Goal : 3/5 Improve maternal healthImprove maternal health Goal : 4/6Goal : 4/6 Combat HIV/AIDS, malaria and Combat HIV/AIDS, malaria and

other diseasesother diseases Goal : 5/7Goal : 5/7 Ensure environmental Ensure environmental

sustainabilitysustainability Goal: 6/8Goal: 6/8 Develop a global partnership for Develop a global partnership for

developmentdevelopment

MILLENNIUM DEVELOPMENT MILLENNIUM DEVELOPMENT GOAL INDICATORSGOAL INDICATORS

Eradicate extreme poverty and hungerEradicate extreme poverty and hunger Reduce Child MortalityReduce Child Mortality Improve Maternal HealthImprove Maternal Health Combat HIV/AIDS, malaria and other Combat HIV/AIDS, malaria and other

diseasesdiseases Ensure environmental sustainabilityEnsure environmental sustainability Develop a global partnership for Develop a global partnership for

development development

Health SystemHealth SystemThe “health system” is intended toThe “health system” is intended to

deliver health servicesdeliver health services

Medical CareMedical Care““Medical Care refers chiefly to Medical Care refers chiefly to

those personal services that are those personal services that are provided directly by a physician or provided directly by a physician or rendered as a result of the rendered as a result of the physician’s instructionsphysician’s instructions” ”

Levels of Health CareLevels of Health Care

Primary health carePrimary health care Secondary Health CareSecondary Health Care Tertiary Health CareTertiary Health Care