Blogs

• A measure of disease burden including both:
– Quality and
– Quantity of life lived
• Used mainly for assessing the value for money of a medical intervention i.e. cost – effective analysis for comparing different interventions
• Based on the number of QUALYs gained by the intervention
• Each year in perfect health = 1.0
• Death = 0.0
• 1 QUALY = one year of life X one utility value = one year of life lived in perfect health
• Half a year lived in perfect health is equivalent to 0.5 QUALY = 1 year X 0.5 utility value

• Previously k/a DALE (Disability Adjusted Life Expectancy)
• Definition: equivalent number of years in “full health” that a new-born can expect to live based on current rates of ill health and mortality
• Indicator used to measure healthy life expectancy
• Based on:
o life expectancy at birth BUT
o Includes an adjustment for time spent in poor health as perceived by the individuals in the following areas of their personal health:
1. Sensory ( vision, hearing and speech),
2. Mobility,

Life expectancy (LE) estimates are insensitive to the health status of the population.
They provide no indication of the quality of life, only the quantity
Moving beyond LE are the indicators below:

1 HALE (Health – Adjusted Life Expectancy)
2 “Sullivan’s index” or Disability – free life expectancy or Active life expectancy
3 QALY (Quality – adjusted life years)
4 Disability – adjusted life years (DALY)

‘Sullivan’s index’ also k/a ‘Disability Free Life Expectancy’ or “Active Life Expectancy”
• ‘Life expectancy’ MINUS ‘duration of disability’
• Health expectancy calculated by Sullivan’s method is the number of remaining years, at a particular age, that an individual can expect to live in a healthy state.
• The data for calculation is obtained from
o population surveys and
o life tables
• This data is often readily available.

Disability Adjusted Life Years (DALY) – Measuring the burden of disease in a population
Why measure the burden of disease?
1. To aid in setting health service priorities
2. To aid in identifying disadvantaged groups and targeting of health interventions;
3. To provide a comparable measure of output for planning and evaluation.
DALYs as a measurement tool
1. Burden of disease is measured in terms of TIME
• i.e., The TIME of healthy living lost due to disease or premature death

Eligible Couples
• Definition: a currently married couple wherein the wife is in the reproductive age (i.e. 15 -49 yr. of age)
• Appx. 150 – 180 eligible couples per 1000 population in India
• These couples are in need of family planning services
• The “eligible couple register” is maintained and updated by the ANM/ MPHW/ ASHA

1) Crude birth rate

2) General fertility Rate

3) General marital fertility rate (GMFR): It is the number of live births per 1000 married women in the reproductive age-group (15 – 49 yr.) in a given year

These newborns would need special care and should be referred to the FRU

Objective
• To assist the newborn in adaptation to the extra-uterine environment
This involves the following:
1. Cardio – respiratory function: Initiation of respiration and oxygenation of blood
2. Body temperature maintenance
3. Feeding establishment
4. Infection prevention
5. Early detection and management of:
• Congenital disorders
• Other disorders
• Infection

Confirmation of Pregnancy:
The simple way to confirm pregnancy in the first trimester is to conduct a urine examination using a pregnancy test kit.
The kit detects pregnancy on the basis of presence of HCG in the urine
The test can be performed soon after a missed period and simple to perform
The pregnancy test should be offered to any women who is in reproductive age group and comes with a history of amenorrhea or symptoms of pregnancy
The kit made available by the GOI is k/a ‘Nischay’