Vital Statistics

- Statistics refers three systematic approaches of obtaining, organizing, and analyzing numerical
facts so that conclusion may be drawn from them.
- Vital statistics refers to a systematic study of vital events such as birth, illnesses, marriages,
divorce, separation, and death.
- Statistics of death and disease indicate the state of health of the community and the success or
failure of health work.
- Statistic on population and the characteristics such as age and sex are obtained from the
National Statistic Office (NSO)
- Births and deaths are registered in the Office of the Local Civil Registrar of the municipality or
city. In cities, births and deaths are registering at the City Health Department.

Use of Vital Statistics:

 Indices of the health and illness status of community.

 Serves as basis for planning, implementing, monitoring, and evaluating community health
nursing programs and services.

Sources of Data:

 Population census
 Registration of vital data
 Health survey
 Studies and researches

Rates and Ratios:

- Rate shows the relationship between vital event and those person exposed to the occurrence of
said event, within a given area and during a specified unit of time, it is evident that the person
experiencing the event(numerator) must come from the total population exposed to the risk on
the same event(denominator).
- Ratio is used to describe the relationship between two numerical quantities or measures of
events without taking particular considerations to the time or place.
- Crude or General Rates refer to the total living population. It must be presumed that the total
population was exposed the risk of occurrence of the event.
- Specific Rate the relationship is for a specific population class or group. It limits the occurrence
of the event to the portion of the population definitely exposed to it.
- Crude Birth Rate a measure of one characteristic of the natural growth or increase of a
population.
- Crude Death Rate a measure of one mortality from all causes which may result in a decrease of
population.
- Infant Mortality Rate measures the risk of dying during the first year of life.
- Maternal Mortality Rate measures the risk of dying from causes related to pregnancy,
childbirth, and puerperium.
- Fetal Death Rate measures pregnancy wastage. Death on the product of conception occurs prior
to its complete expulsion, irrespective of duration of pregnancy.
 - Neonatal Death Rate measure the risk in dying the first month of life.
- Specific Death Rate describes more accurately the risk of exposure of certain classes or groups
to a particular disease.
- Incident Rate measures the frequency of occurrence of the phenomenon during a given period
of time.
- Prevalence Rate measures the proportion of the population which exhibits a particular disease
at a particular time. This can only be determined following a survey of a population concerned
deals with total (new and old) number of cases.
- Attack Rate a more accurate measure of risk of exposure.
- Proportionate Mortality (Death Ratios) shows the numerical relationship between death from
all causes, age, etc. and the total no. of deaths from all causes in all age is taken together.
- Case Fatality Ratio index of killing power of a disease and it's influenced by incomplete
reporting and morbidity data.

Formulas:

Total No .of live births registered ∈a given calendar year

CBR= x 1000
Estimated population as of July 1 of same year
Total No. of deaths registed∈a given calendar year
CDR= x 1000
Estimated population as of July 1of same year
Total No . of death under 1 year of age registered ∈a given calendar year
IMR= x 1000
Total No. of registered live births of same calendar year

MMR=Total No . of deaths ¿ maternal causesregistered for a given year ¿

Total No .of live births registered of same
Total No. of Fetal Deaths registered ∈a givencalendar year
FDR= x 1000
Total No . of live births registered of same year
No . of Deaths under 28 days of age registered∈a given calendar year
NDR= x 1000
No . of live births registered of same year
Deaths ∈specific class /group registed∈ a given calendar year
SDR= x 1000
Estimated population as of July 1∈same specified class group of said year

No . of new cases of particular disease registered during a specified period of time

IR= x 1000
Estimated population as of July of same year

No. of new∧old casesof certain disease regitered at agiven time

PR= x 1000
Total No . of person examined at the same giventime

No. of personsacquiring a disease registered∈a given year

AR= x 1000
Estimated population as of July of same year
PM =No. of registered deaths ¿ specific cause∨age for a givencalendar ¿ all causes, all a
No . of registrationdeath ¿

CFR=No . of registered deaths¿ specific disease for a given year ¿ same specific disease ∈s
No . of registered cases ¿

Presentation of Data:

- Observation of events in the community are presented in the form of tables, charts, and graphs.

Most commonly used graphs in presenting data:

- Line or curved graphs – show peaks, valleys and seasonal trends. Also used to show the trends
of birth and death rates over a period of time.
- Bar graphs - each bar represents or expresses a quantity in terms of rates or percentage of a
particular observation like causes of illness and deaths.
- Area Diagram – (pie chart) shows the relative importance of parts to the whole.

Functions of the Nurse:

 Collects data
 Tabulates data
 Analyzes and interprets data
 Evaluates data
 Recommends redirection and/or strengthening of specific areas of health programs as needed.

Field Health Services and Information System (FHSIS)

Objectives:

 To provide summary of data on health services delivery and selected program accomplished
indicators at the barangay, municipality/city, district, provincial, regional and national levels
 To provide data which when combined with data from other sources can be used for program
monitoring and evaluation purposes.
 To provide a standardized facility-level data base which can be accessed for a more in-depth
study.
 To ensure that the data reported to the FHSIS are useful and accurate and or disseminated in a
timely and easy-to-use fashion.
 To minimize the recording and reporting burden at the service delivery level in order to allow
more time for patient care and promotive activities.

Components:

 Family treatment record

 Target client list
 Reporting forms
 Output reports
Treatment Record

- The fundamental building block or foundation of the FHSIS.

- This a document, form or pieces of paper upon which the presenting symptoms or complaints
of the patient on consultation and the diagnosis (if available), treatment, and date of treatment
is recorded.
- This record will be maintained as part of the system or records at each BHS/BHC/RHU/MHC, or
hospital outpatient facility and all patients seen.

Rx Record
Date Name Address Complaint Rx Diagnosis
(If available)

Target/Client Lists

The target client list constitutes the second “building block” of the FHSIS and are intended to serve four
purposes:

1. The plan and carry out patient care and service delivery.
2. To facilitate the monitoring and supervision for services.
3. To report services delivered.
4. To provide a clinic level data base which can be accessed for further studies.

The target/client list to be maintained in the revised FHSIS:

 Target client List for Expanded Program on Immunization

 Target group List for Eligible Population
 Target client List for Children 0 to 59 months (Risk, Under-five children)
 Target client List for Nutrition
 Client list for Prenatal Care
 Client list Postpartum Care
 Client list for Family Planning (Non-surgical methods)
 List for TB Symptomatic
 Client list for TB cases under Short-Course Chemotherapy
 Client list for TB cases under Standard Regimen (SR)
 Client list for Leprosy Cases

Tally/Reporting Forms

- FHSIS Reports constitute the only mechanism through which data are routinely transmitted
from one facility to another in the revised FHSIS.
- The majority of FHSIS reports are prepared and submitted either monthly or quarterly.
- One report is prepared weekly, several annually, and in some instance every few minutes as
relevant event occurs.
 - Reports are prepared and submitted by the unit/person responsible for the service/activity
being provided and sent directly to the Provincial Health Office.
- The bulk of data reported from the RHU/MHC/BHS/BHC level are activities which are
undertaken or are the responsibilities of midwives/nurses.

Under the current system, however, all reports will be transmitted to the PHO without intermediate
levels of data handling.

List of FHSIS Reports and Forms

Reports/Forms No. Title Reporting Responsibility
Upon Occurrence of Events
FHSIS/E-1 Notification of Death Form BHS/BHC/RHU/MHC
FHSIS/E-2 Maternal Death Report BHS/BHC/RHU/MHC
FHSIS/E-3 Perinatal Death Report DH/CH
Weekly
FHSIS/M-1 Weekly Report of Notifiable BHS/BHC/RHU/MHC
Diseases
Monthly
FHSIS/M-1 Monthly Field Health BHS/BHC/RHU/MHC
Services Activity Report DH/CH/PH/CHO/RH

FHSIS/M-2 Monthly Natality Report BHS/BHC/RHU/MHC

FHSIS/M-3 Monthly Mortality Report RHU/MHC

FHSIS/M-4 Monthly Laboratory Report RHU/MHC/DH
CH/PH/CHO
FHSIS/M-5 Monthly Dental Health Service RHU/MHC/DH
Report CH/PH/CHO/RH

FHSIS/M-6 Family Planning subsidized RHU/MHC/DH

Surgical Procedure Report CH/PH/CHO/RH

FHSIS/M-7 Monthly Social Hygiene Clinic STD Clinic

Activity Report
Quarterly
FHSIS/Q-1 Quarterly Field Health BHS/BHC/RHU/NMHC
Services Activity Report DH/CH/PH/CHP/RH
FHSIS/Q-2 Quarterly Dental Facility DH/CH
Inspection Report
FHSIS/Q-3 Quarterly Report of RHU/MHC/DHO
Environmental Health Activities
FHSIS/Q-4 Quarterly Reports and Malaria DHO/CHO/PHO
Control Activities
FHSIS/Q-5 Drugs and Supplies RHU/MHC
Quarterly Status Report
FHSIS/Q-6 Laboratory Supplies RHU/MHC/DH/CH
Quarterly Status Report PH/CHO
Annual
 FHSIS/A-1 Annual Catchment Area OPT/BHS/BHC/RHUMHC
Tally Sheet and Summary
Report
FHSIS/A-2 Annual Catchment Area BHS/BHC/RHU/MHC
Population Summary Report
FHSIS/A-2A Annual Catchment Area BHS/BHC/RHU/MHC
OPT Form
FHSIS/A-3 Annual Household RHU-SI/MHC-SI
Environmental Sanitation
Report
FHSIS/A-3A Annual Environmental RHU/MHC/DHO
Household Survey Form
FHSIS/A-4 Annual Nutrition Report BHS/BHC/RHU/MHC/DH
Food Supplement CH/PH/CHO/RH

Output Reports

Output Report or Table will be produced at the PHO from the data reported in FHSIS
disseminated down to the RHU/MHC and up to through the DOH system o the Regional Health Office.

Objective: To make the reports useful for monitoring/management purposes at each level of DOH
management.

FHSIS Components

Family Treatment
Record

Target/Client Tally/Reporting
List Forms Output Tables

Facility-based Means of
Data Transmitting Outcome
Data

Records, Reports and Patient Flow

 All information related to client/patients history, complaint, diagnosis, services and/or
treatment is containing in 3 documents or records: (1) Individual Treatment Record (2) Target/Client List
(3) Tally sheet/report forms.

Geographic Coding

The FHSIS Report forms are to be submitted by the reporting units.

Reporting unit - DOH health care facility that renders/delivers public care-related services to targeted
beneficiaries.

Barangay Health Station (BHS) - lowest level of reporting unit. Catchment area.

Rural Health Unit (RHU) or Main Health Center (MHC) - next level of reporting unit.

BHS can be considered a reporting unit if the following conditions are satisfied.

 It renders/deliver health services to define catchment area Which may be composed of one or
more barangays.
 A midwife renders regular service to the area.
 Health services may be provided. For any physical structure, this ignited for the purpose.
 The catchment areas served is not a service are of any RHU.
 It should not include satellite BHS which are visited by the midwives but part of the catchment
of the “mother BHS”.

The ff are considered reporting units and expected to submit FHSIS reports:

 BHS/BHC - Barangay Health Station/Barangay Health Centers

 RHU/MHC - Rural Health Unit/Main Health Center
 PH/CHO - Provincial Hospital/City Health Office
 RH - Regional Health