TOOLS USED IN COMMUNITY

DIAGNOSIS: DEMOGRAPHY,
VITAL AND HEALTH
STATISTICS
EPIDEMIOLOGY
Biostatistics
Demography
Study of population size,
composition and spatial
distribution as affected by births
and deaths and migration.
Sources
Census complete enumeration of the
population
De jure people were assigned to place where
they usually live regardless of where they are at
the time of the census
De facto people were assigned to place where
they physically present at the time of the census

Components
Population Size
Population Composition
Age distribution
Sex ratio
Population pyramid
Median age
Age dependency ratio
Other characteristics
Occupational groups, Economic group,
Educational attainment, Ethnic group

Population Distribution
Urban Rural
Crowding Index indicates the ease by
which a communicable disease can be
transmitted from one host to another
susceptible host
Population Density determine the
congestion of the area/place
Vital statistics
The application of statistical
measurements to vital events such as
births, deaths and common illness that is
utilized to gauge the levels of health,
illness and health services of a
community.
Fertility rate
Crude birth rate
General fertility rate
Mortality rates
CDR
Specific mortality rates
Infant mortality rate
Neonatal mortality rate
Post-neonatal rate
Maternal mortality rate
Morbidity rates
Prevalence rate
Incidence rate
HEALTH INDICATORS.
A list of information determined the
health of a particular community
particularly the population.
TYPES OF HEALTH INDICATORS
CBR Crude Birth Rate
CDR Crude Death Rate
IMR Infant Mortality/Morbidity Rate
MMR Maternal Mortality/Morbidity Rate
NDR - Neonate Death Rate
IMPORTANCE/IMPLICATION OF
HEALTH STATISTICS
It is a tool in planning, implementation
and evaluating health programs.
Serves as indexes of the health
condition obtaining in a community or
population group.
Provide variables due as to the nature
of health services or action needed.
Serves as basis for determining the
success or failure of such services or
actions.

Crude Birth Rate (CBR )
Refers to the number of live birth/1000
population (fertility rate).

CBR = # of total registered live birth x 1,000
Estimated mid year population
Crude Death Rate (CDR)
Refers to the deaths/1000 population. This
also measures the force of mortality in a 1
year calendar.

CDR = # of total deaths x 1,000
Estimated mid year population
Infant Mortality Rate (IMR)
Pertains to the number of death under 1
yr/ 1000 live births

IMR = # of deaths under1 yr. X 1,000
# of registered live births
Maternal Mortality Rate (MMR)
Refers to the number of deaths related to
pregnancy/ 1000 population.

MMR = # of deaths related to pregnancy x 1,000
# of registered live births
Neonatal Death Rate (NDR)
Refers to the total number of deaths
among individual below 28 days old.

NDR = # of deaths under 28 days x 1,000
# of registered live births
Barangay Wakat, Nagcarlan, Laguna has an
estimated mid year population of 550 for
the year 2007. In the same year 250 live
births are registered at the Municipal Hall.
There are 75 deaths from any cause of
disease, which occurs, in the same year.
There are 7 mothers who died resulting
from pregnancy, labor and delivery at the
same year. 15 babies dies during prenatal
and post natal period.

Compute for the following: CBR, CDR, IMR,
MMR
Given:
population = 550
# of registered live births = 250
# of registered deaths = 75
# of deaths resulting from pregnancy = 7
# of babies deaths = 15
1. CBR = # of total registered live birth x 1,000
Estimated mid year population

= (250/550) x 1,000
= 454 / 1,000 population

Interpretation: There are 454 live births per
1,000 population
2. CDR = # of total deaths x 1,000
Estimated mid year population
= (75/550) x 1000
= 136 / 1,000 population

Interpretation: There are 136 deaths per
1,000 population
3. IMR= # of deaths under1 yr. X 1,000
# of registered live births

= (15/250) x 1,000
= 0.06/ 1,000 population

Interpretation: There are 0.06 infant mortality
rate per 1,000 population
4. MMR= # of deaths related to pregnancy x 1,000
# of registered live births

= (7/250) x 1,000
= 0.028 / 1,000 population

Interpretation: There are 0.028 maternal
mortality rate per 1,000 population
Incidence Rate
This measures the frequency of
occurrence of the phenomenon during a
given period of time. Deals only with new
cases.

No. of new cases of a particular disease
IR = registered during a specific period of time x 100,000
estimated population as of July of same year
Prevalence Rate
This measures the proportion of the
population which exhibits a particular
disease at a particular time. This can only
be determined following a survey of the
population concerned. Deals with the total
number of old and new cases.

No. of new and old cases of a certain
PR = disease registered at a given time x 100
total number of person examined at
same given time
Epidemiology
The study of the distribution of disease or
physiological condition among human
populations and the factors affecting such
distribution.
The study of the occurrence and
distribution of health conditions such as
disease, death, deformities or disabilities
on human populations.
IMPORTANCE AND USES OF
EPIDEMIOLOGY IN PUBLIC
HEALTH

Serve as backbone of the prevention of
diseases
Uses of Epidemiology: according to
Morris
To study the history of the health
population and the occurrences of disease
To diagnose the health of the community
and the condition of people
To study the working of health services
with a view of improving them
To estimate the risks of disease,
accidents, defects and the chances of
avoiding them
Factors affecting distribution
Person
Intrinsic characteristics
Place
Extrinsic factors
Time
Temporal patterns
Patterns of Disease Occurrence
ENDEMIC places where diseases are
regularly experience; occurrences of disease are
constant. Example: malaria
EPIDEMIC when disease occurs in short
duration of time or season. Example: measles,
chickenpox, dengue.
PANDEMIC when disease occurs worldwide.
Example: SARS, AIDS, cholera
SPORADIC - when disease occurs on and off.
Example: rabies, tetanus
Steps in EPIDEMIOLOGICAL
INVESTIGATION
Establish fact of presence of epidemic
Establish time and space relationship of
the disease
Relate to characteristics of the group in
the community
Correlate all data obtained
Establish fact of presence of
epidemic
Verify diagnosis
Reporting
Is there an unusual prevalence of the
disease
Establish time and space
relationship of the disease
Are the cases limited to or concentrated in
a particular area
Relation of cases by days of onset to
onset of the first known cases (usually
done in weeks)
Relate to characteristics of the
group in the community
Relation of cases to age, groups, sex,
color, occupation, school attendance, past
immunization.
Relation of sanitary facilities
Relation to milk and food supply
Relation of cases to other cases and
known carriers if any

Correlate all data obtained
Summarize the data
Draw final conclusion
Establish source of epidemic and the
manner of the spread
Make suggestions as to the control and
preventions of future outbreaks
Outline on the operational
procedure during a disease
outbreak
Organization team
Epidemiological investigation
Collection of laboratory specimens
Treatment of patients and contacts
Immunization campaign
Environmental sanitation
Health education
Involvement of other agencies
Reporting
Health Care Delivery System
the network of health facilities and
personnel, which carry out the task of
rendering health care to the people.

Types Services Types of
health
services
Examples
Primary
Health promotion,
preventive care
Continuing care for
common health
problems, attention
to psychological and
social care, referrals
Health promotion
and illness
prevention
Information
dissemination
Secondary
Surgery, medical
services by
specialist
Diagnosis and
Treatment
Screening
Tertiary
Advances,
specialized,
diagnostic,
therapeutic and
rehabilitative care
Rehabilitation PT/OT
Strategies and Methodologies in
CHN
Priority for the vulnerable groups
Infants (0 1 year old)
Children (1 4 y.o.)
Women of reproductive age (15 44 y.o.)
Adolescent
Elderly
Key Approach
PRIMARY HEALTH CARE
Levels of Health Care
Health Promotion
Individual wellness
Family wellness
Community wellness
Environmental
wellness
Social wellness
Disease Prevention
Primary
Secondary
Tertiary
Focus on screening
Case finding
Contact tracing
Multi-phasing screening
surveillance