COMMUNITY HEALTH NURSING  PHS is intended to serve as one of the bases for

LECTURE planning, implementation, and assessment of

health programs and services of health
HEALTH INDICATORS authorities at various levels of health sectors
 Quantitative measures usually expressed as SOURCES OF DATA
RATES, RATIO, or PROPORTIONS that
1. POPULATION STATISTICS
describe and summarize various aspects of the
2. NATALITY AND MORTALITY STATISTICS
health status of the population
3. NOTIFIABLE DISEASE STATISTICS
 Also used to determine factors that may
contribute to a causation and control of
CLASSIFICATION OF DATA
diseases, indicates priorities for resource 1. GEOGRAPHIC CLASSIFICATION
allocation, monitors implementation of health 2. AGE
programs, and evaluates outcomes of health 3. DISEASE AND CAUSE OF DEATH
programs 4. SEX
EPIDEMIOLOGY ANALYSIS AND INTERPRETATION OF DATA
 Study of the DISTRIBUTION and 1. SMALL FREQUENCIES
DETERMINANTS of health-related states or 2. COMPUTATION OF STATISTICAL INDICIES
events in specified population and its application 3. COMPLETENESS OF REGISTRATION AND
to the prevention and control of health problems NOTIFICATION
 DISTRIBUTION: analysis by time, places and DEFINITION OF TERMS
classes of people affected ATTENDED
 DETERMINANTS: include biological, chemical,  Refers to the cases given medical care at any
physical social, cultural, economic, genetic, and point in time during the course of the illness
behavioral factors that influence health which directly caused death. Medical care may
Practical Applications: either be provided directly by a medical doctor
1. Assessment of the health status of the or indirectly by allied health care providers, i.e.,
community or community diagnosis nurses and midwives who are under direct
2. Elucidation of the natural Hx of disease supervision of a medical doctor. Otherwise, case
3. Determination of disease causation is categorized as “death unattended”
4. Prevention and control of disease BIRTH ORDER
5. Monitoring and evaluation of health  Numerical order of a child in relation to all
interventions previous pregnancies of mother
6. Provision of evidence for policy formulation BIRTH WEIGHT
TYPES OF HEALTH INDICATORS  First weight of the fetus or newborn obtained
1. MORBIDITY after birth
- Prevalence CRUDE BIRTH RATE (CBR)
- Incidence  Measure of one characteristics of the natural
2. MORTALITY growth or increase of a population
- Crude and specific death rates CRUDE DEATH RATE
- Maternal mortality  Measure of one mortality from all causes which
- Infant mortality may result in a decrease of population
- Neonatal mortality CRUDE OR GENRAL RATES
- Postnatal mortality  Referred to total living population. Must be
- Child mortality presumed that total population was exposed to
3. POPULATION the risk of the occurrence of the event
- Age-sex structure of the population DEATH
- Population density  Permanent disappearance of all evidence of life
- Migration at any time after live birth has taken place
- Population growth (crude birth rate, FETAL DEATH
fertility rate)  Death prior to complete expulsion or extraction
4. PROVISION OF HEALTH CARE of a product of conception from its mother;
- Access to health programs and facilities death is indicated by after separation fetus does
- Availability of health resources not breathe or show any other evidence of life,
DATA such as heartbeat, pulsation of umbilical cord,
or definite movement of voluntary muscles
 the Philippine Health Statistics (PHS) series is
the DOH’s annual publication that compiles FETAL DEATH RATE
statistics on vital health events providing  Measures pregnancy wastage. Death of the
comprehensive summary of the country’s product of conception prior to its complete
current statistics on NATALITY, MORBIDITY, expulsion, irrespective of duration of pregnancy
AND MORTALITY INICIDENCE RATE (IR)
 PHS is a product of the collaborative effort of the
Philippine Statistics Authority
  Measures frequency of occurrence of the population exposed to the risk of same event
phenomenon during a given period of time. (denominator)
Deals only with new cases. INFANT RATIO
MORTALITY/DEATH  Used to describe the relationship between 2
 Death of an infant under 1 yr of age. INFANT numerical quantities or measures of events
MORTALITY RATE (IMR) without taking particular considerations to the
 Measures risk of dying the 1st yr of life. It is a time or place. Quantities not necessarily
good index of the general health condition of a represent same entities, although unit of
community since it reflects the changes in the measure must be the same for both numerator
environmental and medical conditions of a and denominator of the ratio
community SPECIFIC DEATH RATE
LATE FETAL DEATH  Describes more accurately the risk of exposure
 Death of fetus with 28 or more completed weeks of certain classes or groups to particular
of gestation diseases. To understand the forces of mortality,
LIVE BIRTH rates should be made specific provided the data
 Complete expulsion or extraction from its are available for both population and event in
mother of a product of conception, irrespective their specifications. Specific rate render more
of duration of the pregnancy, which after such comparable results and thus, reveal problems
separation, breathes or shows any other of public health
evidence of life SPECIFIC RATE
MATERNAL MORTALITY/DEATH  Relationship is for a specific population class or
 Death of a woman while pregnant or within 42 group. It limits the occurrence of the event to
days of termination of pregnancy, irrespective of that portion of the population definitely exposed
the duration and site of pregnancy, from any to it
cause related to or aggravated by the pregnancy TOTAL FERTILITY RATE (TFR)
or its management, but not from accidental or  Number of children a woman would have by the
incidental causes time she reaches age 50 under a given fixed
MATERNAL MORTALITY RATE (MMR) fertility schedule. Sometimes referred to as
 Measures risk of dying from causes related to completed family size. Average number of births
pregnancy, childbirth, and puerperium. It is an per 100 females aged 15-49 years
index of the obstetrical care needed and USUAL RESIDENCE
received by the women in a community  Place where the person/deceased habitually or
NEONATAL DEATH permanently resides
 Death among live births during the first 28 FORMULA OF VITAL HEALTH INDICATORS
completed days of life
NEONATAL DEATH RATE (NDR)
 Measures the risk of dying during the 1st month
of life. May serve as index of effects of prenatal
care and obstetrical management on the
newborn
PLACE OF OCCURRENCE
 Refers to the place where vital event took place
PREVALENCE RATE (PR)
 Measures proportion of the population which
exhibits a particular disease at a particular
time. Can only be determined following a survey
of the population concerned. Deats with total
(old and new) number of cases
PROPORTIONALE MORTALITY (PM)
 Shows numerical relationships between deaths
from a cause, age, and total number of deaths
from all causes in all ages taken together. Not a
measure of risk of dying
RATE
 In vital statistics, it shows relationship between
a vital event and those persons exposed to the
occurrence of said event, within a given area
and during a specified unit of time. It is evident
that the persons experiencing the event
(numerator) must come from the total
 along the health system pillars of FINANCING,
SERVICE DELIVERY, REGULATION,
GOVERNANCE, PERFORMANCE
ACCOUNTABILITY
THREE STRTEGIC GOALS OF F1 PLUS FOR
HEALTH
1. BETTER HEALTH OUTCOMES
2. MORE RESPONSIVE HEALTH SYSTEM
3. MORE EQUITABLE HEALTHCARE FINANCING
BETTER HEALTH OUTCOMES
- Health sector will sustain gains and address new
challenges in:
- MATERNAL NEWBORN & CHILD HEALTH
- NUTRITION
- COMMUNICABLE DISEASE ELIMINATION
- NON COMMUNICABLE DISEASE
PREVENTION & TREATMENT
- Improvements in health outcomes will be measured
through sentinel indicators
 LIFE EXPECTANCY
 MATERNAL & INFANT MORTALITIES
 NON COMMUNICABLE DISEASE
MORTALITIES
 TUBERCULOSIS INCIDENCE
 STUNTING AMONG UNDER 5 YR OLDS
MORE RESPONSIVE HEALTH SYSTEM
 Quality of health goods and services as well as
the manner in which they are delivered to the
population will be improved to ensure people-
centered healthcare provision
 Done thru instruments that routinely monitor
and evaluate client feedback on health goods
used and services received
MORE EQUITABLE HEALTHCARE FINANCING
 Access of Filipinos (poor and undeserved) to
affordable and quality health goods and services
will be expanded thru mechanisms that provide
them with adequate financial risk protection
from the high and unpredictable cost of
healthcare
 reduce catastrophic OOP payments such as thru
public subsidies targeted towards the poor
PILLARS OF F1
FINANCING
SUSTAINABLE INVESTEMENTS FOR EQUTABLE
HEALTHCARE
General objective #1
 sustainable investments for health secured,
efficiently used, and equitable allocated for
improved health outcomes
Specific Targets:
 more resources for health efficiently mobilized
and equitably distributed
 health spending rationalized
NATIONAL OBJECTIVES FOR HEALTH  financial resources focused towards high impact
 Serves as the medium-term roadmap of the intervention
Philippines towards achieving universal SERVICE DELIVERY
healthcare WIDER ACCESS TO ESSENTIAL HEALTHCARE
 Specifies objectives, strategies, and targets of General objective #2
DOH FOURmula One Plus for Health built
  access to essential quality health products and
services ensured to appropriate levels of care
Specific Targets:
 access to quality essential health products and
services increased
 equitable access to quality health facilities
ensured
 equitable distribution of Human Resources for
Health (HRH) guaranteed
 service delivery networks organized and engaged
REGULATION
SAFE, QUALITY, AND AFFORDABLE HEALTHCARE
General objective #3
 high quality and affordable health products,
devices, facilities, & services ensured
Specific Targets:
 regulatory systems and processes harmonized
and streamlined
 innovative regulatory mechanisms developed for
equitable distribution of quality and affordable
health goods and services
GOVERNANCE
FUNCTIONAL AND PEOPLE-CENTERED HEALTH
SYSTEM
General objective #4
 strengthened leadership and management
capacities, coordination, and support
mechanisms necessary to ensure functional,
people centered and participatory health
systems
Specific Targets:
 strengthened sectoral leadership and
management
 improved processes for procurement and supply
chain management that ensure the availability
and quality of health commodities
 ensured generation and use of evidence in
health policy development, decision-making, &
program planning and implementation
PERFORMANCE ACCOUNTABILITY
TRANSPARENT AND RESPONSIVE HEALTH SECTOR
General objective #5
 better health attained thru transparent,
responsive, & responsible health sector
management
Specific Targets:
 transparency and accountability measures at all
levels institutionalized
 outcome-based management approach used