INDICATORS OF
HEALTH
DR. MAHESWARI JAIKUMAR.
maheswarijaikumar2103@gmail.com

DEFINITION
• Demography is the "study of
human populations in relation to
the changes brought about by
the interplay of births, deaths,
and migration" PRESSAT

DEFINITION
• "Demography is the statistical
description and analysis of
human population". - WRONG

• Demography is the "statistical and
mathematical study of the size,
composition and spatial distribution
of human populations, and of the
changes over time, in these aspects
through the operation of the five
processess of fertility, mortality,
marriage, migration and social
mobility" - BOGUE

USES OF DEMOGRAPHIC DATA
• Analyse patterns and trends
related to human religion,
nationality, education and
ethnicity.

• Estimates are reliable standards
for judging the accuracy of the
census information gathered at
any time.

• Estimates size and flow of
populations of workers; in
population ecology, the focus
is on birth, death and
movement of firms and
institutional forms.

• Uses administrative records to
develop an independent
estimate of the population.

• Provides insight into the links
between these characteristics
and cultural, economic,
geographic and other social
attributes present in a given
area.

• Demographic analysis is a
powerful tool that can explain a
number of sociological
phenomena.

• Used to estabilish the
percentage of the total
population involved in a
particular resource use
activity, such as fishing or
tourism.

• Apply to whole societies or to
groups defined by criteria such
as education, nationality,
religion and ethnicity.

• Analyzes the relationship
between economic, social,
cultural and biological
proceses influencing a
population.

• Time and age have special
relationships in popultion
studies, from which cross
sectional and cohort analysis are
developed.

• Relates to whole societies or
to a smaller groups defined
bycriteria such as education,
religion or ethnicity.

• Develops targeted outreach and
training activities for local
communities.

DEMOGRAPHIC INDICATORS
• 1. Measurement of Mortality.
• 2. Measurement of Morbidity.
• 3. Measurement of disability.

• 4. Measurement of natality.
• 5. Measurement of the presence,
absence or distribution of the
characteristics or attributes of
the disease.

• 6. Measurement of medical
needs, health care facilities,
utilization of health services
and other health related
events.

• 7. Measurement of the
presence, absence or
distributionof the
environmental and other
factors suspected of causing
the disease.

• 8. Measurement of
demographic variables.

DEMOGRAPHIC INDICATORS :(Eg)
• Crude Birth Rate. (CBR)
• General Fertitlity Rate. (GFR)

• Crude Death Rate. (CDR)
• Infant Mortality Rate. (IMR)

• Life expectancy. (LE)
• Total Fertility Rate. (TFR)

• Gross Reproduction Rate.(GRR)
• Net Reproduction Rate. (NRR)

BIRTH RATE (BR)
NUMBER IF LIVE BIRTHS DURING
THE YEAR.
ESTIMATED MID YEAR
POPULATION
X 1000BIRTH RATE =

GENERAL FERTILITY RATE (GFR)
NUMBER OF LIVE BIRTHS
DURING A YEAR.
MID YEAR FEMALE POP (15-49)
IN THE SAME YEAR
X 1000GFR =

GENERAL MARITAL FERTILITY RATE
(GMFR)
NUMBER OF LIVE BIRTHS
DURING A YEAR.
MID YEAR MARRIED FEMALE
POP (15-49) YRS
GMFR = X 1000

AGE SPECIFIC FERTILITY RATE
(ASFR)
NUMBER OF LIVE BIRTHS IN A
PARTICULAR AGE GROUP.
MID YEAR POP OF THE
SAME AGE GROUP
ASFR = X 1000

AGE SPECIFIC MARITAL FERTILITY
RATE (ASMFR)
NUMBER OF LIVE BIRTHS IN A
PARTICULAR AGE GROUP.
MID YAER POP OF THE SAME AGE
GROUP.
ASMFR = X 1000

TOTAL FERTILITY RATE (TFR)
• It is the average number of
children a women can give
birth throughout the
reproductive period.

• It is represented by summing the
age specific fertility rates for all
ages; if 5 - year age groups are
used, the sum of the rates is
multiplied by 5.

TFR
45 - 49
15 – 19
1000
TFR =
5 X ASFR∑

TOTAL MARITAL FERTILITY RATE
(TMFR)
Average number of children that
would be born to a married
women if she experiences the
current fertility pattern through
her reproductive span.

TMFR
45 - 49
15 -19
1000
5 X ∑ ASMFRTMFR =

GROSS REPRODUCTION RATE (GFR)
• Average number of girls that
would be borne to a women if
she experiences the curent
fertility pattern throught her
reproductive span (15 - 49 years)
having no mortality.

NET REPRODUCTIVE RATE (NRR)
• NRR is defined as the number of
daughters a new borne girl will
bear during her lifetime
assuming fixed age-specific
fertility and mortality rates.

• At presesnt in India NRR is
about 1.5.
• If NRR is < 1, then the
reproductive performance of
the population is said to be
below replacement level.

MARRIAGE RATES
• The marriage rate (CRUDE
MARRIAGE RATE) is the
number of marriages per 1000
total population in a given
year.

CHILD WOMAN RATIO
• Is the number of children 0 - 4
yrs of age per 1000 women of
child bearing age.

PREGNANCY RATE.
• It is the ratio of number of
pregnancies in a year to
married women in the ages
15-49 yrs.

• The "number of pregnancies"
includes all pregnancies,
whether or had terminated as
live births, stillbirths or
abortions or had not yet
terminated.

ABORTION RATE
• The annual number of all
types of abortions, usually per
1000 women of child bearing
age (15-19 yrs).

ABORTION RATIO
• This is calculated by dividing
the number of abortions
performed during a particular
time period by the number of
live births over the same
period.

CRUDE DEATH RATE (CDR)
NUMBER OF DEATHS DURING A
YEAR
MID YEAR POPULATION
CDR = X 1000

SPECIFIC DEATH RATE
NUMBER OF DEATHS FROM TB DURING A
CALENDER YEAR.
MID YEAR POPULATION
SDR = X 1000

SPECIFIC DEATH RATE IN AGE GROUP
15-20 YRS
NUMBER OF DEATHS OF
PERSONS AGED 15-20
DURING A CALENDER
YEAR.
MID YEAR POPULATION
OF PERSONS AGED 15-20
SPECIFIC DEATH
RATE (15-20 YRS) = X 1000

DEATH RATE FOR JANUARY
DEATHS IN
JANUARY X 12
MID YEAR
POPULATION
DEATH RATE
FOR JAN =
X 1000

WEEKLY DEATH RATE
DEATHS IN THE WEEK
MID YEAR POPULATION
WEEKLY DEATH
RATE = X 1000

CASE FATALITY RATIO
TOTAL NUMBER OF
DEATHS DUE TO A
PARTICULAR DISEASE
TOTAL NUMBER OF
CASES DUE TO THE
SAME DISEASE
X 100CFR =

PROPORTIONAL MORTALITY RATIO
NUMBER OF DEATHS FROM
THE SPECIFIC DISEASE IN
A YEAR
TOTAL DEATHS FROM ALL
CAUSES IN THAT YEAR
X 100PMR =

SURVIVAL RATE
TOTAL NUMBER OF PATIENTS
ALIVE AFTER 5 YEARS
TOTAL NUMBER OF PATIENTS
DIAGNOSED OR TREATED
SURVIVAL
RATE = X 100

STANDARDIZED MORTALITY RATIO
OBSERVED DEATHS
EXPECTED DEATHS
SMR = X 100

INFANT MORTALITY RATE (IMR)
NUMBER OF DEATHS OF
CHILDREN LESS THAN 1
YEAR OF AGE IN A YEAR
NUMBER OF LIVE BIRTHS IN
THE SAME YEAR
X 1000IMR =

ATTACK RATE
NUMBER OF NEW CASES OF
A SPECIFIED DISEASE
DURING A SPECIFIED TIME
INTERVAL
TOTAL POPULATION AT RISK
DURING THE SAME
INTERVAL
X 100AR =

STILL BIRTH RATE (SBR)
FOETAL DEATHS WEIGHING
OVER 1000g AT BIRTH
DURING THE YEAR
TOTAL LIVE + STILL BIRTHS
WEIGHING OVER 1000g AT
BIRTH DURING THE YEAR
X 1000SBR =

PERINATAL MORTALITY RATE (PMR)
LATE FOETAL AND EARLY
NEO NATAL DEATHS
WEIGHING OVER 1000g
AT BIRTH
TOTAL LIVE BIRTHS
WEIGHING OVER 1000g
AT BIRTH
X 1000PMR =

NEONATAL MORTALITY RATE
(NMR)
NUMBER OF DEATHS OF
CHILDREN UNDER 28
DAYS OF AGE IN A YEAR
TOTAL LIVE BIRTHS IN THE
SAME YEAR
X 1000
NMR =

POST NEONATAL MORTALITY RATE
NUMBER OF DEATHS OF CHILDREN
BETWEEN 28 DAYS AND ONE
YEAR OF AGE IN A GIVEN YEAR
TOTAL LIVE BIRTHS IN THE SAME
YEAR
X 1000PNMR =

CHILD DEATH RATE
NUMBER OF DEATHS OF
CHILDREN AGED 1-4
YEARS DURING A YEAR
TOTAL NUMBER OF
CHILDREN AGED 1-4
YEARS AT THE MIDDLE OF
THE YEAR
X 1000CDR =

CHILD MORTALITY RATE
NUMBER OF DEATHS OF
CHILDREN LESS THAN 5
YEARS OF AGE IN A GIVEN
YEAR
NUMBER OF LIVE BIRTHS IN
THE SAME YEAR
X 1000CMR =

CHILD SURVIVAL INDEX
1000 - UNDER 5
MORTALITY RATE
10

MATERNAL MORTALITY RATIO
TOTAL NUMBER OF FEMALE DEATHS
DUE TO COMPLICATIONS OF
PREGNANCY, CHILDBIRTH OR
WITHIN 42 DAYS OF DELIVERY
FROM PUERPERAL CAUSES IN AN
AREA DURING A GIVEN YEAR
TOTAL NUMBER OF LIVE BIRTHS IN
THE SAME AREA AND YEAR
X 1000 /
100000MMR =

DISABILITY RATES
• INDICATORS USED TO MEASURE
DISABILITY :
1. SULLIVAN INDEX
2. HEALTH ADJUSTED LIFE
EXPECTANCY (HALE).
3. DISABILITY ADJUSTED LIFE
YEAR

SULLIVAN INDEX
LIFE EXPECTANCY - (PROBABLE
DURATION OF BED DISABILITY +
INABILITY TO PERFORM MAJOR
ACTIVITIES)

HEALTH ADJUSTED LIFE EXPECTANCY
(HALE)
• Is an indicator of health which
measures healthy life
expectancy.
• HALE is equivalent to the
number of years newborn child
expected to live with full health.

DISABILITY ADJUSTED LIFE YEAR
(DALE)
• Is used to express the years of
life lost to premature death and
years lived with disability for
severity of disability.
• ONE DALY = ONE LOST YEAR OF
HEALTHY LIFE

CASE RATE
Number of reported cases
of a specific disease or
illness
100,000 population during
a given year

EMIGRATION RATE
NUMBER OF EMIGRANTS
DEPARTING AN AREA OF
ORIGIN
1000 POPULATION AT
THAT AREA OF ORIGIN IN
A GIVEN YEAR

NET EMIGRATION RATE
The net effect of immigration and
emigration on an area's
population (increase or
decrease) is refered to as net
migration.

• The net migration shows the net
effect of immigration &
emigration on an area's
population of the area in a given
year.

GROWTH RATE
The growth rate is the rate at
which a population is increasing
(or decreasing) in a given year
due to natural increase and net
migration, expressed as a
percentage of the base
population.

• The growth rate takes in to
account all components of
population growth: births, deaths
and migration.

LIFE EXPECTANCY
The number of years which an
individual at a given age could
expect to live, at present
mortality levels

THE WORLD BANK REPORT
VITAL INDICATORS -INDIA

IMR
46/1000 (2010).
45/1000 (2011).
43/1000 (2012).
41/1000 (2013).

MATERNAL MORTALITY RATE
• 220/10,000 Live
Birth (2010).
• 190/10,000 Live
Birth (2013).

CRUDE BIRTH RATE
• 21/1000 Pop (2010).
• 21/1000 Pop (2011).
• 21/1000 Pop (2013).

CRUDE DEATH RATE
• 8/1000 Pop (2010).
• 8/1000 Pop (2011).
• 8/1000 Pop (2012).

ANNUAL GROWTH RATE (%)
• 10 (2010).
• 6.6 (2011).
• 4.7(2012).
• 5 (2013).

NET REPRODUCTION RATE
1.4 (2012).

LIFE EXPECTANCY
66 Yrs (2010).
66 Yrs (2011).
66 Yrs (2012).

NATIONAL HEALTH
POLICY
GOALS……..

SPECIFIC GOALS 1983 2000
INFANT MORTALITY RATE 125 BELOW 60
PRE SCHOOL CHILD RATE 24 10
CRUDE DEATH RATE 14 9
MATERNAL MORTALITY RATE 4.5 BELOW 2
LIFE EXPECTANCY AT BIRTH
MALES
FEMALES
52.6
51.6
64
64
CRUDE BIRTH RATE 35 21
ANNUAL GROWTH RATE 2.33 1.22

SPECIFIC GOALS 1983 2000
NET REPRODUCTION
RATE
1.48 1
COUPLE PROTECTION
RATE
23.6 60
FAMILY SIZE 4.40 2.3
ANTE NATAL COVERAGE 40.50 100
DELIVERIES BY TRAINED
BIRTH ATTENDENTS (%)
30.35 100

SPECIFIC GOALS 1983 2000
IMMUNIZATION STATUS (%
COVERAGE)
TT-PREGANANT WOMEN 20 100
DPT 25 85
POLIO (INFANTS) 5 85
BCG (INFANTS) 65 85

THANK YOU