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Index - Same Level Subject
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Demographic Indicators
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Socioeconomic Indicators
Mortality Indicators
Morbidity Indicators
Indicators of Resources, Access, and Coverage
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Index - Child Subjects
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Population with access to health services
Given the complexity of its functions, measurement of coverage by the health
system is not easy. The degree of coverage and social access can vary
considerably between the primary and tertiary levels of care. Even within the
primary level there are differences between immunization programs, mental health
care, and the treatment of cardiovascular diseases, for example. In the 1994
edition of Health Conditions in the Americas, an access indicator was defined,
based on two basic services fundamental to health care: care at the moment of
birth and care at the moment of death. Delivery coverage was defined as the
percentage of births attended by trained personnel versus the total estimated
births. For deaths, coverage was defined as the percentage of deaths registered
with a medical certification versus the total estimated deaths. The percentage
of the population with access to health services is calculated as the average of
these two values.
Unit of measure: Percent
Percent of urban population with reasonable access to public sources of
potable water
The population that has reasonable access to drinking water. In urban areas the
criterion for determining "reasonable access" is a distance of 200 meters from
housing to a public water source. In rural areas the definition of access is
more flexible and depends on the topography and other environmental factors.
Unit of measure: Percent
Percent of urban
population served by individual systems of excreta disposal
In urban areas, this is the population whose dwellings have septic tanks and
latrines. In rural areas this indicator refers to the individual systems (for
the most part latrines) but also includes other systems such as the septic tanks
and drains.
Unit of measure: Percent
Percent of rural population having adequate sanitary of excreta disposal
In rural areas this indicator refers to the individual systems (for the most
part latrines) but also includes other systems such as the septic tanks and
drains.
Unit of measure: Percent
Percent of population
with access to disinfected water supplies
Proportion of the population who has access to drinking water that has been
disinfected by methods that eliminate biological agents at concentration levels
that are hazardous to health.
Unit of measure: Percent
Percent of urban
population with regular collection of solid waste
This measure refers to urban areas where permanent systems and periodic
collection of solid waste is available.
Unit of measure: Percent
Percent of children under
1 year attended by trained personnel
It is the percentage of infants who have had at least one consultation during
the first year of life with a trained health worker.
Unit of measure: Percent
Percent of pregnant women
attended by trained personnel during 1st trimester of pregnancy
Pregnant women who have received at least one consultation during the first
trimester of pregnancy and not only services immediately prior to delivery. Does
not include direct vaccination activities, already included in another
indicator, but does include monitoring of the pregnancy and ambulatory care for
associated morbidity. The trained personnel refer to the ability to provide the
necessary supervision, care and advice to women during pregnancy, labor and the
post-partum period, to conduct deliveries on their own responsibility and to
care for the newborn and the infant. Since the number of pregnant women is
generally not available, the number of live births is used as a denominator.
Unit of measure: Percent
Percent of deliveries attended by trained personnel
The number of deliveries attended by trained personnel in a given year versus
the total number of births in that same year. The trained personnel refer to the
ability to provide the necessary supervision, care and advice to women during
pregnancy, labor and the post-partum period, to conduct deliveries on their own
responsibility and to care for the newborn and the infant. The site of the
delivery is not taken into account.
Unit of measure: Deliveries
Number of graduates in
medicine
The total number of individuals obtaining a medical doctor degree from a
recognized university in a given year.
Unit of measure: Physicians
Population per
university-trained professional nurse
The ratio, for a specific year, between the mid-year population and the number
of university-trained professional nurses (Registered Nurse equivalent).
Unit of measure: Inhabitants per nurse
Number of university graduates in professional nursing
The total number of individuals obtaining a nursing degree (Registered Nurse
equivalent) from a recognized university in a given year.
Unit of measure: Nurses
Population per non-university trained nursing personnel
The ratio, for a specific year, between the mid-year population, and the number
of qualified (by formal education or special training) personnel, which are
authorized, under national regulations to provide personal care (observation and
direct care) to the population, for problems related to health. Depending on the
level of education there are several categories: auxiliary, assistant,
technician, licensed, etc. with several specializations, many times the training
is in-service.
Unit of measure: Inhabitants per nursing personnel
Under-registration of births
The lack of registry of a vital event, even late, is called Under-registration.
Under-registration of the births is the ratio of births not registered until one
year after the birth, to the total estimated births, expressed as a percentage.
Unit of measure: Percent
Tetanus toxoid vaccination among women of childbearing age (12 to 49 years)
living in high-risk areas
High-risk areas are defined as geographical units that have registered a higher
frequency of neonatal tetanus than the national average in the five years prior
to the report. The vaccination coverage is represented by the cumulative
percentage of women 12 to 49 years old that has received at least two doses of
tetanus toxoid during the last 5 years.
Unit of measure: Percent
Percent of birth
registrations that are for children over 1 year old at time of registration
It is the ratio between the number of births certificates issued for children
who were 1 year of age or older at the time of registration and the total
children registered in a given year.
Unit of measure: Percent
Deaths with medical care as a percentage of
registered deaths
The percentage of deaths registered with
a death certificate signed by a physician. This is an additional indicator for
measuring the quality of death registries.
Unit of measure: Percent
E.1- Proportion of
population with access to drinking water services
DEFINITION: The number
of people with access to drinking water services in a given year, expressed as a
percentage of the corresponding population of that year, in a given country,
territory, or geographic area.
TECHNICAL NOTE: Access
to drinking water services is defined as direct access through household
connections to drinking water systems and/or reasonable access through public
drinking water sources. Reasonable access to drinking water services is defined
by a distance from housing to a public water source of no greater than 1
kilometer and minimum of 20 liters per person per day. Data are provided by
PAHO/WHO country offices and technical regional programs based on information
reported by the national health authority.
TYPE: Proportion
MEASURE UNITS: Percent
CATEGORIES: Total,
Urban, Rural, Urban with household connection, Urban without household
connection
E.2- Proportion of
population with access to sanitation services
DEFINITION: The number
of people with access to sanitation services in a given year, expressed as a
percentage of the corresponding population for that year, in a given country,
territory, or geographic area.
TECHNICAL NOTE: Access
to sanitation services is defined as direct access through household connections
to public sewerage systems as well as to individual systems such as septic tanks
(disposal of wastewater and excrement) or latrines (disposal of excrement). Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Proportion
MEASURE UNITS: Percent
CATEGORIES: Total,
Urban, Rural, Urban with household connection, Urban without household
connection
E.6- Proportion of
under-1 population vaccinated against poliomyelitis
DEFINITION: The number
of children who, on completing their first year of life, have received three
doses of live oral poliomyelitis vaccine (OPV), expressed as a percentage of the
corresponding mid-year population, for a specific year, in a given country,
territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national systems for disease prevention and
control.
TYPE: Proportion
MEASURE UNITS: Percent
E.7- Proportion of
under-1 population vaccinated against measles
DEFINITION: The number
of children under 1 year of age or the number who are 1 year old, depending on
the national immunization scheme, who have received one dose of vaccine against
measles, expressed as a percentage of the corresponding mid-year population, for
a specific year, in a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the reported by the national systems for disease
surveillance and control.
TYPE: Proportion
MEASURE UNITS: Percent
E.8- Proportion of
under-1 population vaccinated against diphtheria, pertussis, and tetanus
DEFINITION: The number
of children who, on completing their first year of life, have received three
doses of DPT (diphtheria, pertussis, and tetanus), expressed as a percentage of
the corresponding mid-year population, for a specific year, in a given country,
territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the reported by the national systems for disease
surveillance and control.
TYPE: Proportion
MEASURE UNITS: Percent
E.9- Proportion of
under-1 population vaccinated against tuberculosis
DEFINITION: The number
of children under 1 year of age or the number who are 1 year old, depending on
the national immunization scheme, who have received one dose of vaccine against
tuberculosis (BCG), expressed as a percentage of the corresponding mid-year
population, for a specific year, in a given country, territory, or geographic
area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the reported by the national systems for disease
surveillance and control.
TYPE: Proportion
MEASURE UNITS: Percent
E.10- Prevalence of
use of contraceptive methods in women of childbearing age
DEFINITION: The number
of women aged 15 to 49 years who currently use any type of contraceptive method,
at a specific point in time, expressed as a percentage of the corresponding
mid-year population, for a given year, in a given country, territory, or
geographic area. Contraceptive methods include female and male sterilization,
injectable and oral contraceptives, intrauterine devices, diaphragms,
spermicides, condoms, rhythm method, withdrawal and abstinence.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Proportion
MEASURE UNITS: Percent
E.11- Specific
fertility rate in women 15-19 years of age
DEFINITION: The ratio
between the number of live births born to mothers aged 15 to 19 years during a
given year and the mid-year female population 15 to 19 years of age, usually
multiplied by 1,000.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Rate
MEASURE UNITS: Per
1,000 women 15-19 years of age
E.12- Proportion of
pregnant women attended by trained personnel during pregnancy
DEFINITION: The number
of pregnant women who have received at least one health care visit during
pregnancy provided by a trained health worker, expressed as a percentage of the
live birth population, for a given year, in a given country, territory, or
geographic area. Health care visit during pregnancy is defined as those health
care services for the control and monitoring of the pregnancy and/or ambulatory
care for associated morbidity; it does not include direct vaccination activities
or health care services rendered immediately prior to delivery. Trained
personnel are those with acquired ability to provide the necessary supervision,
care, and advice to women during pregnancy, labor and puerperium, and to conduct
deliveries.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Proportion
MEASURE UNITS: Percent
SUBCATEGORIES: since
the first trimester of pregnancy
E.13- Proportion of
deliveries attended by trained personnel
DEFINITION: The number
of deliveries assisted by trained personnel in a specific year, regardless of
their site of occurrence, expressed as a percentage of the total number of
births in that same year, in a given country, territory, or geographic area.
Trained personnel are those with acquired ability to provide the necessary
supervision, care, and advice to women during pregnancy, labor and puerperium,
to conduct deliveries, and to care for the newborn and infant.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Proportion
MEASURE UNITS: Percent
E.15- Physicians per
10,000 inhabitants ratio
DEFINITION: The number
of physicians available per every 10,000 inhabitants in a population, in a given
year, for a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
10,000 inhabitants
E.16- Professional
nurses per 10,000 inhabitants ratio
DEFINITION: The number
of university-trained professional nurses available per every 10,000 inhabitants
in a population, in a given year, for a given country, territory, or geographic
area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
10,000 inhabitants
E.17- Dentists per
10,000 inhabitants ratio
DEFINITION: The number
of dentists available per every 10,000 inhabitants in a population, in a given
year, for a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
10,000 inhabitants
E.21- Number of
outpatient care facilities
DEFINITION: The number
of outpatient health care facilities, of all types of institutional affiliation,
in operation during a given year, in a given country, territory, or geographic
area. Outpatient health care is defined as any professional encounter or
contact, as an act of health service, between a non-hospitalized individual and
a health worker responsible for the evaluation, diagnosis, treatment, or
referral of that individual.
TECHNICAL NOTE:
Institutional affiliation includes any outpatient health care facility managed
by the Ministry of Health or a governmental equivalent, by Social Security
systems, including those for the Police and Armed Forces, and by private,
for-profit or non-profit, voluntary-driven or not, organizations. Data are
provided by PAHO/WHO country offices and technical regional programs based on
information reported by the national health authority.
TYPE: Absolute
Magnitude
MEASURE UNITS:
Facilities
CATEGORIES: Total,
Ministry of Health, Social Security, Private Sector
E.22- Hospital beds
per 1,000 inhabitants ratio
DEFINITION: The number
of hospital beds available per every 1,000 inhabitants in a population, in a
given year, for a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
1,000 inhabitants
E.23- Outpatient
health care visits per 1,000 inhabitants ratio
DEFINITION: The number
of outpatient health care visits per every 1,000 inhabitants in a population, in
a given year, for a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
1,000 inhabitants
E.24- Hospital
discharges per 1,000 inhabitants ratio
DEFINITION: The number
of hospital discharges per every 1,000 inhabitants in a population, in a given
year, for a given country, territory, or geographic area. Hospital discharge is
defined as the formal release of a hospitalized patient due to conclusion of the
hospitalization stay, either by death, return home, or transfer to another
institution. A hospital is defined as any medical facility with an organized
professional medical staff and beds available for continuous hospitalization of
patients formally admitted for medical observation, care, diagnosis, or surgical
and non-surgical treatment.
TECHNICAL NOTE: Data
are provided by PAHO/WHO country offices and technical regional programs based
on information reported by the national health authority.
TYPE: Ratio
MEASURE UNITS: Per
1,000 inhabitants
E.25- Annual
national health expenditure per capita (current US$)
DEFINITION: The
average per capita value of the sum of public and private expenditures on health
care goods and services for a given national economy, of a given period in time,
usually a year, expressed in current US dollars. Health expenditure includes the
provision of preventive and curative health services, public health affairs and
services, health applied research, and medical supply and delivery systems, but
it does not include provision of water and sanitation.
TECHNICAL NOTE:
National health expenditure includes the total amount of expenditure of a
country on health care goods and services. Public health expenditure consists of
capital and recurrent spending of central and local governments, including
transfers to other government institutions, external borrowings and grants, and
health spending of social security systems. Private health expenditure includes
household out-of-pocket payments and copayments for formal and informal health
services, drugs, prosthetic devices, and private health insurance; charitable
donations and spendings of companies with employee health services and health
insurance. Information on public health spending was drawn from official country
sources, such as reports from the Ministry of Health and Social Security
Institutions, National Health Accounts studies, and official statistical
yearbooks and reports from the IMF on government finances. Secondary sources
include statistical series published by international organizations as well as
financial and spending estimates reported in sectorial studies with reliable
primary source data. Data on private health spending was taken from National
Health Accounts studies and reports from household surveys on income and family
spending or multipurpose surveys.
TYPE: Index
MEASURE UNITS: US
Dollars per capita
E.26- Annual
national health expenditure as a proportion of the GDP
DEFINITION: The value
of the sum of public and private expenditures on health care goods and services
for a given national economy, at a given period in time, usually a year,
expressed as a percentage of the corresponding gross domestic product (GDP).
Health expenditure includes the provision of preventive and curative health
services, public health affairs and services, health applied research, and
medical supply and delivery systems, but it does not include provision of water
and sanitation.
TECHNICAL NOTE:
National health expenditure includes the total amount of expenditure of a
country on health care goods and services. Public health expenditure consists of
capital and recurrent spending of central and local governments, including
transfers to other government institutions, external borrowings and grants, and
health spending of social security systems. Private health expenditure includes
household out-of-pocket payments and copayments for formal and informal health
services, drugs, prosthetic devices, and private health insurance; charitable
donations and spendings of companies with employee health services and health
insurance. Information on public health spending was drawn from official country
sources, such as reports from the Ministry of Health and Social Security
Institutions, National Health Accounts studies, and official statistical
yearbooks and reports from the IMF on government finances. Secondary sources
include statistical series published by international organizations as well as
financial and spending estimates reported in sectorial studies with reliable
primary source data. Data on private health spending was taken from National
Health Accounts studies and reports from household surveys on income and family
spending or multipurpose surveys.
TYPE: Proportion
MEASURE UNITS: Percent
E.27- Annual public
health expenditure as a proportion of the national health expenditure
DEFINITION: The size
of the public expenditure on health care goods and services for a given national
economy, of a given period in time, usually a year, expressed as a percentage of
the corresponding national health expenditure. It represents the governmental
share, not limited to the Ministry of Health, of the total annual expenditure
for covering the provision of preventive and curative health services, public
health affairs and services, health applied research, and medical supply and
delivery systems, excluding the provision of water and sanitation.
TECHNICAL NOTE:
National health expenditure includes the total amount of expenditure of a
country on health care goods and services. Public health expenditure consists of
capital and recurrent spending of central and local governments, including
transfers to other government institutions, external borrowings and grants, and
health spending of social security systems. Private health expenditure includes
household out-of-pocket payments and copayments for formal and informal health
services, drugs, prosthetic devices, and private health insurance; charitable
donations and spendings of companies with employee health services and health
insurance. Information on public health spending was drawn from official country
sources, such as reports from the Ministry of Health and Social Security
Institutions, National Health Accounts studies, and official statistical
yearbooks and reports from the IMF on government finances. Secondary sources
include statistical series published by international organizations as well as
financial and spending estimates reported in sectorial studies with reliable
primary source data. Data on private health spending was taken from National
Health Accounts studies and reports from household surveys on income and family
spending or multipurpose surveys.
TYPE: Proportion
MEASURE UNITS: Percent
E.31-
Underregistered deaths
DEFINITION: The
difference between the number of estimated deaths and the number of currently
registered deaths, expressed as a percentage of the total estimated deaths in a
given year, in a given country, territory, or geographic area.
TECHNICAL NOTE: Data
are quinquennial estimations.
TYPE: Proportion
MEASURE UNITS: Percent
E.33- Proportion of
registered deaths due to ill-defined conditions
DEFINITION: The number
of death certificates issued in a given year for which the underlying cause of
death was symptoms, signs, and ill-defined conditions (ICD-9 codes 780-799;
ICD-10 codes R00-R99), expressed as a percentage of the total registered deaths
for that same year, in a given country, territory, or geographic area.
TYPE: Proportion
MEASURE UNITS: Percent
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