sheeloopoonam@yahoo.com's blog

• 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

This blog explains which newborns require special care and must be referred to a First Referral Unit (FRU). It covers three major categories: (1) birth asphyxia and its complications including convulsions, shock, hypoxia, hypoglycaemia, and renal failure; (2) key neonatal danger signs such as fast breathing, severe chest indrawing, temperature abnormalities, feeding difficulty, lethargy, unconsciousness, jaundice, and bleeding; and (3) major congenital malformations like meningomyelocoele, hydrocephalus, large omphalocoele, diaphragmatic hernia, and esophageal atresia. The blog is aligned with Park’s Textbook of Preventive and Social Medicine and Government of India maternal-newborn care guidelines, helping MBBS students and practitioners identify high-risk newborns early and ensure timely referral.

This blog explains Essential Newborn Care (ENC) in a simple and structured way for MBBS students. It covers the objectives of ENC, immediate care at birth, airway clearance, APGAR assessment, cord and skin care, prevention of hypothermia, and early initiation of breastfeeding. It also details first and second neonatal examinations, measurements, congenital anomalies, danger signs, and criteria for identifying high-risk infants. The content is aligned with Government of India guidelines and Park’s textbook, providing an accurate, exam-friendly, and clinically relevant guide to newborn care.

This blog provides a comprehensive explanation of Antenatal Care (ANC), including pregnancy confirmation with urine tests, early registration importance, objectives of ANC, recommended visit schedule, first-visit procedures, physical and abdominal examination, fundal height interpretation, routine lab tests, IFA and TT recommendations, dietary guidance, personal hygiene, drug and radiation precautions, identification of danger signs, and national guidelines applicable at subcenter, PHC and FRU levels.

This blog explains the key components of specific health protection during ANC visits—screening and prevention of anemia, nutritional deficiencies, toxemias of pregnancy, tetanus, syphilis, rubella, Rh incompatibility, HIV, hepatitis B, and prenatal genetic disorders—based on Indian public health and maternal care guidelines.