PHC1 PHC2 PHC3

Inst. 200 300 500

Delivery
Fully 150 250 350
Immunized
children
Sterilizatio 100 150 200
n
 PHC1 PHC2 PHC3
Population 20000 40000 80000
covered
Birth rate 25 25 25

Inst. 200 300 500

Delivery
Fully 150 250 350
Immunized
children
Sterilizatio 100 150 200
n
What is it?
 A thing that indicates  a variable (its value
the state or level of changes)
something (Oxford
dictionary)  that measures
(objective calculation
 Quantitative or
of value)
qualitative variable that
provides a simple and
 a single aspect of a
reliable means to reflect
program or project
the changes connected  Input, process, output,
to an intervention outcome
Indicator components
 What is to be measured
 what is going to change
 Unit of measurement to be used to describe the
change
 Pre-program status/state, baseline
 Size, magnitude, or dimension of the intended
change
 Quality or standard of the change to be achieved
 Target population(s)
 Timeframe
Types of indicator
 Indicators are used at
every stage of project Identification

cycle Completion
and lesson Preparation
 Performance learning
 Input
 Process
 Output Evaluation Appraisal

 Outcome Implementatio
n/ Monitoring
 e sua
nt
ob •rel C
je ev ifi on important
cti anab sis
ve • tle
Programmatically
Ote
s an us
pe nt
an din ra ly Timely
d ap gtiom
re •prav
na
A ea
su op ail
lly
ccsu Measurable
lts riab
de
urra
of atle bl
fiat
yo eto ne
e Precise
ur in ol
dm in
pr tesineath
og ran e
clsu Reliable
ra md ea
resa
m sm rofm
ofet
teae Valid
pr
ho
rbew
og
ds
mhaay
rasviby
mor, di
obpr ffe
jeac re
What makes a good indicator?
nt
ctitic
veeob
Indicator Pyramid
Decreases

Global Number of
Compare countries
Overview world-wide situation Indicators

Increases
National/Sub-national
Assess effectiveness of response
Reflect goals/objectives of national/sub-national response

District or Facility
Identify progress, problems, and challenges
 Data Aggregation
8

Item Total
(Block)
Delivery 200
Live Births 200
 Data Aggregation
9

Item SC1 SC2 SC3 SC4 Total

(Block)

Delivery 100 0 50 50 200

Live 0 100 49 51 200

Births
 Data Quality

REAL WORLD INFORMATION SYSTEM

In the real world, project activities An information system represents these

are implemented in the field. These activities by collecting the results that
activities are designed to produce were produced and mapping them to a
recording system.
results that are quantifiable.

Data Quality: How well the information system represents the real world

Data Quality
1. Accuracy
2. Reliability
Real World 3. Completeness
Information
4. Precision
System
5. Timeliness
6. Integrity
Why is data quality important?

 The only data worth analyzing are high

quality data
 Accountability for funding and results

reported increasingly important

 Quality data needed at program level for

management decisions
Data quality cycle

Improved
Program & Target
Resource Setting
Management Data
Quality

Results
Reporting
 Dimensions of Data Quality
Valid data are considered accurate: They
Validity measure
what they are intended to measure.
The data are measured and collected
Reliability consistently.

Completely inclusive: an information

Complete
system represents the complete list of
ness
eligible names and not a fraction of the list.
Precision The data have sufficient detail.
Data are up-to-date (current), and
Timeliness information is available on time.

The data are protected from deliberate bias

Integrity or manipulation for political or personal
reasons.
 Monthly Reporting Format
14
 Part A. Rep. and child health • Part B.Other programs
– M13.Blindness control program
 M 1Antenatal care services
 M 2 Deliveries • Part C. Health facility
 M 3 C-section deliveries Services
– M14.Patient services
 M 4.Pregnancy outcomes & weight of newborn – M15.Laboratory testing
 M5.Complicatd pregnancies
 M6.Post natal care
• Part D. Monthly inventory
status
 M7.Medical termination of pregnancy – M16.Stock position
 M8.RTI/STI cases
 M9.Family planning
• Part E. Mortality detail
– M17.Details of deaths with
 M10.Child immunization probable causes
 M11.No. of vit A doses
 M12.Number of cases of childhood (0-5 years)
 Quarterly Reporting Format
15
 Part A Status of health Infrastructure
 Q 1. Details of PHCs
 Q2. Details of Anganwadi centres
 Part B Trainings conducted
 Q3. No. doctors trained
 Q4. No. GNM/ANM/LHV trained
 Q 5. No. PMU personnel trained
 Q 6. No. Program Managers trained
 Q 7. Other paramed staff, SOs/asst&AWW
 Q 8. Other trainings
 Part C Additional NRHM Component
 Q 9. State Health Mission
 Q10. District Health Societies
 Q11. ASHAs & Functioning of VHSCs
 Annual Reporting Format
16

**To be submitted BY 30th April of reporting year

 Part A. Demographic
 Part B From the Eligible Couple Register
 Part C Selected Indictors
 Part D Urban Health Infrastructure
 Part E. Status of Health Infrastructure
 Part F. Status of Human resource Availability-Staffing status
 Part G. Infrastructure & accreditation
 Part H. Training
Required Process (monthly from facility, district, state)
Check if all
Districts /
facilities have
Forward filled in the
Data Data for the
Month

Check for the

Feedback Completeness
of Data..
Percentage
filled

Check for Check for

Outliers Validation
errors
 Deliveries at public instts.
18

Ap May June July Aug Sept. Oct Nov Dec Jan Feb Marc Total
ril h

Deliveries 16 17 12 5 8 20 11 2
conducted
at Public
Institution
s
Of which 16 17 12 4 18 11 10
Number
discharge
d under
48 hours
of delivery
 Abortion and MTP
19
Fully Immunized Children
 Immunization sessions planned & held
21

Chattisgarrh April May June July Aug Sept Oct Nov Dec Jan Feb March Total
09-10

Immunization 25650 27109 28658 26591 26780 26661 39182 40784 27289 27972 26256 28055 350987
sessions
planned

Held 23976 26169 29566 26512 26560 26114 33449 52459 27480 26673 25621 27975 352554
 Instances of incomplete data
Data Filled Summary
Status of states with 100 % districts Uploaded the March ’10 data

State Districts Avg. Avg. Avg. Avg.

(Data Items = 227) Filled % Filled value >0 % Zero % Blank %

Andhra Pradesh 23 91.67 57.52 34.15 8.33

Assam 27 74.83 47.48 27.35 25.18
Chhattisgarh 18 85.29 42.61 42.68 14.71
Goa 2 71.81 51.77 20.04 28.19
Himachal Pradesh 12 100 43.13 56.87 0
Jharkhand 24 80.1 43.52 36.58 19.9
Karnataka 29 100 61.77 38.23 0
Manipur 9 100 40.14 59.86 0
Meghalaya 7 92.57 44.36 48.21 7.43
Sikkim 4 94.5 39.1 55.4 5.5
Uttarakhand 13 100 46.12 53.88 0
Chandigarh 1 91.19 54.63 36.56 8.81
Dadra & Nagar 11 60.79 49.34 11.45 39.21
Haveli
Delhi 9 73.76 61.82 11.94 26.24
 Instances of Incorrect / Inconsistent data
• Violation of Functional / definitional dependency
Ma
Data item District Apr y Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total
09 09 09 09 09 09 09 09 09 10 10 10
Number of Complicated
pregnancies 134 526 141 59 172 138 115 152 264 89 150 1940
Number of Complicated
pregnancies treated with IV 250 111
antibiotics 229 355 514 450 105 101 154 0 220 9 250 5997
Number of Complicated
pregnancies 44 31 42 47 41 73 85 207 50 42 249 27 938
Number of Complicated
pregnancies treated with IV
antibiotics 210 256 230 22 386 297 391 215 209 220 193 27 2656
Number of Complicated
pregnancies 0 20 0 0 0 0 0 81 159 156 75 491
Number of Complicated
pregnancies treated with IV
antibiotics 0 10 0 685 74 3 25 797
Number of Complicated
pregnancies 78 62 74 101 131 55 104 89 100 76 55 718 1643
Number of Complicated
pregnancies treated with IV 141 173 153 233 101
antibiotics 22 954 700 552 6 9 3 3 805 6 70 718 11858
 Instances of Incorrect / Inconsistent data
• Violation of Functional / definitional dependency

District Data Item Apr- May- Jun- Jul- Aug- Sep- Oct-
09 09 09 09 09 09 09
Live Birth 187 146 63 62 116 127 120
BCG 154 166 139 125 104 118 153
OPV 0 (Birth Dose) 170 144 114 102 111 128 118
Live Birth 1121 1010 1111 1090 988 1162 1186

BCG 1338 1227 1206 1215 1131 1414 1313

OPV 0 (Birth Dose) 1297 1053 1170 1104 1089 1268 1330
Live Birth 598 606 493 609 549 618 536
BCG 773 841 777 682 757 874 843
OPV 0 (Birth Dose) 412 749 662 449 659 750 755
 Instances of Incorrect / Inconsistent data
• Repeating values – same data in different data items in a month
– same data item across month

Description Apr-08 May- Jun-08 Jul-08 Aug- Sep-08 Oct-08Nov-08

08 08

ANC Regd. 1521 1901 2016 2453 3642 4213 3388

First trimester regn. 1521 1886 1515 1827 2254 3486 3919 3388

New women registered under

212 1576 1515 1827 2254 3486 3919 3025
JSY
Women received 3 ANC check
1733 1576 1515 1827 2254 3486 3919 3035
ups

P regnant women given TT1 1733 1886 1901 2016 2453 3642 3072 3012

Pregnant women given TT2 or

1733 1886 1901 2016 2453 3642 2970 3005
Booster
Pregnant women given 100 IFA
1519 1886 1901 2016 2453 3642 3486 3346
tablets
 Proportion of reported Births (Live + still) to reported deliveries

Data Item North Goa South Goa Total

Total Home deliveries 49 89 138

Deliveries conducted at Public Institutions 12536 8550 22232

Number of Deliveries at accredited Private

Institutions

Live birth 14575 9132 23707

Still Birth 320 58 378

 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
Data Item Total
09 09 09 09 09 09 09 09 09 10 10 10
Immunizatio 1959 1848 19590 1959 1959 1948 1959 1559 0 1848 1449 1848 37926
n session
Planned
Immunizatio 1959 1848 1959 1959 1959 1948 0 1959 0 1848 1449 1848 18736
n session
Held
Immunizatio 0 0 178 138 145 145 144 147 0 0 0 0 897
n session
where
ASHAs were
present
 Instances of Outliers
Distri May Jun- Jul- Aug Sep- Oct- Nov- Dec- Jan- Feb- Mar-
Data Item Apr-09
ct -09 09 09 -09 09 09 09 09 10 10 10
C-section done (Public
31 29 72 232 0 0 0 0 0
Inst.)
C-section done (Public
58 58 17 2 18 35 49 7 343 14 418
Inst.)

Live birth 987 7921225 9272061 661 0 832 593 502 237

Still birth 6 7 9 14 25 3 14 20 21 2 237

1188 1243 1086 1010

Live birth 1152782498239837185649338 44306422
2 3 5 6

Still birth 165 138 138 127 145 173 195 210 136 1033068 77

Newborns weighed at
592 55 84 57 45 54 30 89 54 67 4501380
birth
Newborns less than 2.5
13184068 703 91213 715 783 6061099 421 176 73
kg wt
Some Measures Used in Epidemiology
 Counts: Number of individuals with a certain disease/exposure

 Proportions: (P)
One’s status in relation to group

 Ratio: A fraction in which there is not necessarily any specified

relationship between the numerator & denominator.

 Rate: A ratio in which time forms part of the denominator

 Prevalence: # of existing cases of a disease / health condition in a Po at

some designated time (specified or not).
 Infant Mortality Rate: (IMR) risk of dying during the first year of life among
infants born alive (aged 0-365 days)

 Perinatal MR: measures risk of dying among late fetal death + infant deaths
within the 7 days of birth. (28 weeks gestation to 7 days of life)

 Noenatal MR: measures risk of dying among infants younger than 28 days

 Postneonatal MR: measures risk of dying among older infants (28 days to 12
months)
 Incidence Rate: (IR) rate of development of new cases

 Crude Mortality Rate: (CMR)

# of annual death
Po
 Maternal Mortality Rate: MMR number of maternal death
ascribed to childbirth
 ACCESSIBILITY INDICATOR

•No. of Eligible couples registered/ANM

•No. of Antenatal Care as planned
•% of Sub Centers with no ANM
•% of Sub Centers with working equipment of ANC
•% ANM/TBA without requisite skill
•% of Sub centers with infant weighing machine
•% Sub centers with vaccine supplies
•% Sub centers with Low Osmolar ORS packets and Zinc
•% Sub centers with FP supplies
 QUALITY INDICATOR
•% Pregnancy registered before 12 weeks
•% ANC with 3 visits
•% ANC receiving all RCH services
•% High-risk cases referred
•% High-risk cases followed up
•% Deliveries by ANM/TBA
•%PNC with 3 PNC visits
•% PNC complications referred
•% Eligible couple offered FP choices
•% Women screened for RTI/STDs
•% Eligible couple counselled for prevention of RTI/STDs
•% ADD given Low Osmolar ORS and Zinc
•% ARI treated
•% Children fully immunized
 IMPACT INDICATOR
•%Deaths from maternal causes
•Maternal mortality ratio
•Prevalence of maternal morbidity
•% Low birth weight
•Neo-natal mortality rate
•Prevalence of postnatal maternal morbidity
•% Baby breast-feeds within 1hr of delivery
•Couple protection rate
•Prevalence of terminal method of sterilization
•Prevalence of spacing method
•% Abortion related morbidity
•Prevalence of diarrhoea
•Prevalence of ARI
•Prevalence of RTI/ST
Important indicators to monitor