Measuring health Flashcards
What are three core functions of public health
- Assessment
- Policy development
- Assurance
Describe the precede proceed model
It is a model used in community diagnosis to assess health and quality of life needs for designing, implementing and evaluating PH programs to meet those needs
What are the 5 purposes of public health
- Prevent diseases, injuries and transmission of diseases
- Respond to diseases and help in recoveries
- Protect from environmental hazards
- Assure quality and accessible health services
- Promote healthy behaviors
State any 5 essential PH services
- Assess and monitor population health status
- Investigate diagnose and manage health problems
- Communicate effectively to educate on the health problems, factors that affect them and how to prevent them
- Strengthen support and mobilize communities to improve health
- Create and implement plans and policies that impact health
Define public health
The science of protecting and improving the health of individuals in a community achieved by promoting a healthy lifestyle, preventing injuries and preventing and responding to infectious diseases
The 3 Ps of public health
Preventing disease
Prolonging life
Promoting health
What are the PH interests in a community x3
- Quantifying the occurrence of a disease
- Describing the distribution of a disease
- Describing the determinants of a disease
State any 3 population characteristics
Demographics- age, gender
Socioeconomic status- education, wealth
Lifestyle or behavioral
State 4 aims of population health assessment
Goal setting
Needs assessment
Planning to improve resource allocation
Support policy reviews
State 3 sources of vital statistics
Birth, death and medical data
Define health metrics
Measures of health determinants states and outcomes
What are the importance of health metrics x4
- Assessing the efficacy of health interventions
- Monitoring population health
- Tracking the progression of a disease
- Targeting health investment and activity
What are the challenges of choosing the right health metrics x3
- Lack of financial resources
- Lack of collaboration between the community and health workers
- They may oppose political social and economic systems
What are the challenges of choosing the right health metrics x3
- Lack of financial resources
- Lack of collaboration between the community and health workers
- They may oppose political social and economic systems
Define population health
The health status and outcomes within a group of people
Define city health plan
A plan that addresses the problems of a populations health and strategies to tackle the problems
Describe city health profile
A report that describes the health of a city or population giving information on environmental and social factors that affect health
What are the three objectives for carrying out a health and lifestyle survey
- Obtain baseline information for monitoring patterns of health and changes in health behavior
- Obtain information for planning service provision
- Raise awareness and improve the agenda setting for health promotion
Define health behaviors
Actions that individuals take that can directly influence their health
Consequences of poor health metrics x4
- Poor health status
- Increased cost of health
- Little association between health care investments and health outcomes
- Health disparities by religion race and education
State 5 examples of health behaviors
Smoking
Physical activity
Condom use
Excessive alcohol consumption
Unhealthy diet
What are the reasons for measuring health behaviors x2
Program planning
Program evaluation
Define health status
a measure of how people perceive their health
State methods involved in measuring health status x5
Self reported health status
Physical examinations
Laboratory tests
Disease specific measures
Mortality rates
What are the approaches to measuring health outcome x3
- Compile health outcome measurements into summary statistics
- Assess the distribution of individual health outcome measures
- Measure the function and well being of the population
What are the basic outcome metrics of population health x3
- Measures of mortality life expectancy and premature death
- Measures of health function and subjective well being
- Measures of distribution of health in a population
Define crude mortality
The total number of deaths occurring in an area in a period of 1 year
Define specific mortality
The total number of deaths occurring within a specific group of people
What are the current metrics for measuring population health x5
Infant mortality rate
Condition-specific mortality rate
Age-adjusted mortality rate
Years of potential life lost-premature mortality
Life expectancy at birth
State 5 attributes of a good outcome metric
Valid and reliable
Measurable over time and sensitive to change
Easily understood by people who use them
Measurable with available data sources
Define disease prevalence
The number of disease cases present in a particular population at a given time
Seasonal variation is affected by fluctuations in x3
Recreational and occupational activities
Environmental factors
Define epidemic
Increase in incidence above the expected in a geographical area within a defined time period
Define time clustering
A group of cases occur close together and have a well aligned distribution pattern in terms of time and place
What are the sources of information for descriptive epidemiology x5
Census
Vital statistical records
Employment health examinations
Clinical records from hospitals
National records on food consumption, medications and health events
Describe the epidemiologic approach x4
Identify the problem - clinical suspicion
Formulate the hypothesis
Test the hypothesis
Always question the validity of the results - chance and bias
Describe bias and chance
Chance is the role of random error in outcome measures
Bias is the role of systematic error in outcome measures
Define a hypothesis and what goes into a hypothesis
An educated guess about the source of illnesses based on known information
It contains distribution of disease in terms of Person place and time
Characteristics of a disease ie source of agent, mode of transmission and exposures
Define incidence and incidence rate
•Incidence is the number of new cases of disease that develop in a population at a given time
•Incidence is the rate at which people get the disease
•Incidence rate is the measure of the probability of the event among persons at risk
Define case fatality
The rate at which deaths occur from a disease among those with the disease
Define maternal mortality ratio
Ratio of maternal deaths during child bearing per number of live births within a given time period
Describe probability and odds
Probability is the chance of an event occurring
Odds is ratio of the probability of an event occurring to the probability of an event not occurring
What is the odds ratio for case control studies
Odds of exposure in cases//odds of exposure in controls
What is the odds ratio for cohort and cross sectional studies
Odds of the outcomes in exposed persons/odds of the outcome in non exposed persons
What are the 10 steps of outbreak investigation
Prepare for field work
Establish the existence of an outbreak
Verify the diagnosis
Define and identify cases
Perform descriptive epidemiology
Develop hypotheses
Perform analytic epidemiology-evaluate hypotheses
Refine hypotheses and conduct additional studies
Implement control and prevention measures
Communicate findings- oral or written
What are the objectives of descriptive epidemiology x3
To evaluate trends in health and disease and allow comparison among subgroups or countries
To provide a basis for planning provision and evaluation of services
To identify problems to be studied by analytic methods
Define determinants of health and its 3 categories
The factors that lead to differences in health status
Biological, behavioral, social
Why are BMI classification not used in children x2
They are constantly growing
Their body proportions are changing
Define socioeconomic status and state 3 components
Measure of an adult’s or family’s economic or social position within society relative to others
Income + occupation + education
Define monitoring and evaluation
Monitoring is the routine reporting of program implementation and performance
Evaluation is the periodic assessment of program impact on population level
Importance of M & E x5
Collects accurate information about the project
Improvement of the project effectiveness
It gives feedback on progress
Promotes accountability
Tracking resources
State the pyramid of strategic plan x6
Mission> vision > goals> objectives > performance indicators> activities
What are the tools of monitoring x3
Inputs activities and outputs
What are the tools for evaluation x2
- Outcome- what changes after outputs are produced divided into short medium and long
- Impacts
Define a health indicator
A characteristic of an individual population or environment that is subject to measurement to describe one/more aspects of a program or health outcome
Describe 5 characteristics of a good indicator
Operational- should be measurable using tested definitions
Valid- should measure what it’s intended to measure
Reliable- it should produce the same results when you more than once
Specific- should measure only this condition
Affordable- should represent a reasonable measurement cost
Timely, one directional
Describe the 7 steps involved in planning for monitoring and evaluation
- Identify who will be involved in the design, implementation, and reporting. Engaging stakeholders.
- Clarify scope, purpose, intended use, audience, and budget for evaluation.
- Develop the questions to answer what you want to learn as a result of your work.
- Select indicators.
- Determine the data collection methods.
- Analyze and synthesize the information you obtain
- Interpret these findings, provide feedback, and make recommendations
State 4 aims of the maternal and child health commission
1.To track results and resource flow of W&C health at m country level
2.To identify a core set of indicators and measurement needs for W&C health
3.Propose steps to improve health information and registration of births and deaths in low income countries
4.Explore opportunities for innovation in information technology to improve access to reliable info on resources and outcomes
Define health information system and its 4 data sources
Refers to a system with open data that comes from different sources and that is ethically used to generate strategic information for the benefit of public health
Household survey, censuses, health facility report systems, administrative data systems
What are the challenges faced by HIS x4
Proliferation of indicators creating a reporting burden
Underdeveloped HIS
Unavailability or poor quality data
Poor standard ICT services
What are the ways of strengthening the HIS x5
Investment in data recording systems
Explore and improve the current information and communication technologies
Investment in a universal registration of vital statics and events
Development of harmonized program of health surveys
Support to build the country’s capacity to monitor review and act on data
Differentiate between measures of intervention coverage and measures of impact
Measures of intervention coverage-measures aimed to prevent or reduce exposure of individuals
Measures of impact- assessment of impact based on measured observations
Examples of impact indicators of W&C health x3
- Maternal mortality rate
- Under child mortality rate
- Stunting prevalence U5
Examples of intentional coverage indicators of W&C health x4
Demand for family planning satisfied
Antenatal care
Anti retroviral therapy for HIV positive pregnant women
Skilled attendants at birth
What are the 5 Ps for SDGs
People, planet, peace, prosperity, partnership
How can SDG4 Quality education be achieved x2
Education system must be re imagined
Education financing must be prioritized
What are any 5 challenges encountered in SDG attainment
War and instability
Population growth
Poverty and unemployment
Government issues
Global economy
To achieve SDG6 water and sanitation x3
Boosting infrastructure investment
Improve cross sectoral coordination
Addressing climate change
State any 5 health related MDGs
Eradicate extreme poverty and hunger
Reduce child mortality
Improve maternal health
Combat HIV/AIDS, malaria and other diseases
Ensure environmental sustainability
State 2 challenges faced in the attempt to eradicate extreme poverty and hunger MDG
High illiteracy rates
Inadequate food storage facilities
What strategies can help reduce child mortality rates x5 MDG
1.Increase resource allocation for essential health interventions
2.Improve inter-sectoral collaboration to deal with
other determinants of poor child health
3.Training more health workers
4.Increase immunization of under five children and pregnant women
5.Distribute more free insecticide treated nets and vitamin A
What are the challenges faced in attainment of MDG-improve maternal health x3
Inadequate skilled health personnel
High employee turnover in the health sector.
Lack of health training institutions
Strategies to improve maternal health x4 MDG
Improving the availability of quality Maternal and Neonatal care
Strengthening national and district planning and management of MNH care
Advocating for increased commitment and resources for MNH
Increasing enrolment in health training institutions
Challenges in combating HIV, TB and malaria x3 MDG
Overcrowding and poor nutrition(TB)
Negative social and cultural issues(HIV)
Inadequate knowledge, skills, and shortages of essential commodities
Challenges in achieving environmental sustainability x3 MDG
Poverty
Increasing population growth
Inadequate alternative livelihoods and affordable energy technologies
Aspects of health that are assessed
Determinants of health
Health status
What the DHO District health office needs to know x5
How to manage resources
How the health system works
The health status of a community
Impact of community programs
Where the community is and where it plans to go
Purpose of HMIS health management information system
Provides aggregated data for analysis of the health situation at a national level
Give examples of the categories of health determinants
Biological- blood pressure, blood glucose, blood cholesterol
Behavioral- exercise, smoking, diet
Social- work, transport, housing, access to health care
Differentiate between risk and protective factors in determinants of health
Risk- detrimental to health
Protective- promote or enhance health
State 3 things BMI classifications does not take into account
Muscle mass
Frame size
Bone mass
Effect of good modes of transport x4 in social determinants of health
Improve physical health
Promote social interactions
Reduce fatal accidents
Reduce air pollution
State 4 disadvantages or weaknesses of community involvement in PH interventions
May slow down the process
May lead to community division
Lack of interest if no monetary benefits
Lack of capacity of community members
Unwillingness of community members to make contributions
State 4 strengths of community involvement in PH intervention
Ensures sustainability and cost sharing
Enhancement of knowledge
Increase program acceptance and ownership
Ensures program meets local needs
Describe correlational studies
It is used to determine whether there is statistical association or correlation between 2 variables
Importance of attaining the SDGs x5
Economic growth
Financial stability
Manage climate change
Provide essential human needs
Meet the needs of the present generation
Measurements that are used to assess health x4
Global measurements - problem analysis
Functional measures- perception
Diseases specific measures- problem verification
Utility measures- priority setting
Ways of assessing unmet needs x4
Service demands
Service utilization
Perceptions
Relative availability
State two types of health indicators and 2 examples
Health services indicators - coverage and utilization
Health related socioeconomic indicators - literacy rate and total fertility rate
Reasons for measuring health and disease of a population x5
Planning
Early detection of epidemics
Management and evaluation of healthcare
Identify or prioritize health problems for action
Identify determinants of disease for preventative action
Conditions where incidence is the preferred measurement to prevalence
Disease with a short duration eg cancer. People die shortly after diagnosis so it is not useful to measure prevalence
Define positive predictive value of screening tests
The likelihood that a positive test result indicates the existence of a disease
Define negative predictive value of screening tests
The likelihood that a negative test result represents the absence of the disease
