Measuring+Health


 * Measuring health **


 * a. Life expectancy: **
 * Strengths: **
 * life expectancy data is useful in designing policies that would help to improve health care delivery in a country.
 * Data can be compared across countries to be able to derive the extent to which health care facilities in a country are efficient.
 * It indicates the level of development in a country
 * Weaknesses: **
 * It fails to consider the negative impact that health standards can have on quality of life.
 * It assumes that Life Expectancy is the most important factor in measuring a person’s well being. But other factors such as geographical location, level of education, quality of housing and nutrition equally important indicators.
 * it only shows the length of life of a population however it doesn't indicate how many of such years were lived.


 * b. Infant Mortality rate (IMR):- **
 * ** r ** efers to the number of children who die before their first birthday per 1000 live births.
 * It is also gives a good indication of the level of maternal health.
 * It is lower in countries with higher HDI than countries with lower HDI. Sub-Saharan Africa has the highest IMR in the world.
 * = (__ total no. of deaths of children < 1 year old x1000 per yr)/ __total no. of live births


 * Strengths: **
 * It gives an indication of the level of female education in a country.
 * It gives an indication of the level of health care delivery in a country.
 * it is also an indication of the level of sanitation, nutrition and housing in a country.


 * Weaknesses: **
 * It only gives an indication of child mortality when they are below one. However the death of children above one year is not represented.
 * it does not give an indication of the overall care system in a country.
 * it does not give an indication of the cause of the death of the infant.

Access to healthcare services include:
 * c. Access to health care services **


 * The means of delivery, types of medical personnel, availability of medical facilities or infrastructure eg. Clinics, mobile hospitals, nurses’ and doctors’ training colleges,


 * Advantages.**
 * It tells us about the health delivery system in the country.
 * It indicates the level of infrastructural development in terms of medical facilities including road networks, access to remote areas, ambulance service, internet services e.t.c


 * Disadvantages**
 * It doesn’t give an indication of the quality of healthcare delivery; rather, it indicates the quantity of the healthcare system.. It doesn’t look at other factors involved in measuring health. These include infant mortality, maternal mortality, calorie intake etc.

Calorie intake indicates the level of nutrition or dietary habits of citizens in the country. It is measured in kilocalories per person per day (kcal/person/day). High calorie intake is associated with developed countries, and vice versa. High calorie intake is also associated with obesity and its associated problems and low calorie intake causes malnutrition or undernutrition (marasmus, beriberi, kwashiorkor). Calorie intake measures the amount energy contained in a given amount of food.
 * d. Calorie intake **


 * Advantages**
 * It gives an overall picture of the level of development in terms of food production ie. countries with high calorie intake would usually have an advanced agricultural system. eg. in the EU where 2% of the population is engaged in agriculture and yet they are able to produce to feed the population of over 800m and export the rest.
 * It is a good indicator of other indicators of development like access to safe drinking water, infant mortality, the level of technological advancement, life expectancy etc.
 * It is an easy measure of a country's state of well-being.
 * Data can be used for comparison with other countries/regions/localities to show the extent to which they are are achieving the MDGs.

1. It is not a sufficient measure of a country's state of health; other factors must be combined with calorie intake to give a balanced picture of the country's state of well-being and these include level of education, maternal mortality rate, GNI (Gross National Income) and many others.
 * Disadvantages**

2. The data obtained may not give an idea of the regional variations that may exist in the country.

3. Variations in weather conditions may cause variations in the calorie intake at different times of the year.

World average calorie intake: 2780 kcal/person/day Developed countries: 3420 kcal/person/day Developing world: 2630 kcal/person/day Sub-Saharan Africa: 2240 kcal/person/day Central Africa: 1820 kcal/person/day

This can be used as a yard stick for measuring the health of a population this is because access to safe drinking water can prevent certain water borne diseases such as bilharzia, cholera and guinea worm.
 * e. Access to safe drinking water **
 * Advantages**
 * It can give an indication of the extent of the water borne diseases affecting the people
 * Gives an indication of the level of infant mortality in the country.
 * Indicates the level of economic development of an economy
 * Data obtained can be used for comparison purposes either at the national level or the local level
 * It helps policy makers to make decisions as to what facilities to provide in specific areas.


 * Disadvantages**
 * The data obtained may not give an idea of the regional variations that may exist in the country.

// It is the equivalent number of years in full health that a newborn can expect to live, based on current rates of ill health and mortality. // It was developed by Canadian statisticians in 1990 to overcome the shortcomings of LE. LE and HALE generally increases with the level of education. However the difference between life expectancy and HALE reduces as the level of education rises. Hence those with low level of education tend to have lower LE and vice versa. HALE at birth for men, women and TP in 2002 www.euphix.org/object_document
 * f. HALE (Health-Adjusted Life Expectancy) **

Health-adjusted life expectancy (HALE) at birth for men, women and the total population in the EU, 2002. The method was used to study the population of Canada and it revealed that:
 * There is a wide gap between HALE and LE for women than for men. This gap is known as the burden of ill health.*
 * The wealthier members of society tend to live longer because they have less chronic health problems
 * At age 15, the difference between men and women in terms of LE and HALE is 14% for women and 11% for men. This shows that there is a higher burden of ill health for women.


 * Strengths **
 * it measures both quality and quantity of life
 * Unlike life expectancy which considers all years to be equal, HALE weights the years of life by health status.
 * It is useful as it helps to know the specific group of people in a give population living with a disease.


 * Weaknesses **
 * Lack of reliable data on mortality and morbidity. Morbidity is "a term used to describe the rate of disease in a population or a focus on death." eg. the number of people who have cancer."
 * The data obtained is difficult to compare with data from other health interviews.
 * The fact that women live longer than men does not always mean those additional years are associated with good health. Hence, HALE is not an effective indicator of the state of health.
 * It doesn't measure the disability years of a person. Consequently, a new measure to cater for this weakness is the Disability Adjusted Life Year (DALY).

It is a more complex measure of the cost burden imposed by health on society. It was developed by the WHO and WB in mid 90s to a single digit that measures the impact of premature death and disability. Calculation: DALY = YLL + YLD, //where :// **//YLL//**- Years of Lost Life **//YLD//** - Years Lived with Disability. Hence, DALY calculates one year of healthy life that is lost.*
 * g. Disability-Adjusted Life Year (DALY) **


 * Advantages **
 * It ** is useful in that it helps in identifying the specific groups of people needing specific health needs, such as the lame, crippled, blind etc. This is more reliable than using LE or HALE because it avoids generalizations.
 * It is useful as it helps to know the specific group of people in a give population living with a disability.
 * It tells us the number of premature deaths in a population.
 * It gives an overall picture of the state of health in a country in a more realistic manner than LE.


 * Weaknesses **
 * Critics argue that the weighting of age and discounting (E.g. Of discounting: 3,300 DALYs = 100 Infant deaths) are discriminatory and could lead to the diversion of health care facilities away from those who need it.
 * The method of data collection for DALY is very expensive, making it very difficult for LEDCs to use.
 * Data on DALY relies on weights of disability. (How do you measure the severity of the disease on a scale of 0 to 1?)