IDSB04H3 Chapter Notes - Chapter 4: Maternal Death

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¾ Many countries have limited data collection and rely on what is collected from outside their
¾ Challenges of Health data
o E}ooZ}v]]}v}(o^À]]}vÁ]Z]v}µv]Ç
o Social, environmental, political and economic factors are not included as health statistics
nor are variables such as rainfall, pollution, living conditions and transportation which
can also influence health
o Ensuring the reliability of health statistic collection needs to be made a priority; but this
is difficult particularly in developing countries where the need for health and social
services is high and resources limited and thus funds for data collection are minimal.
¾ Assumptions related to health data: ^]vZu]o]Ì}Zt or
should be t ](]Ç]vu]o]]}vvµo]oÇ}YXvZ]v
agreed-upon nosology t a disease classification process universally applied by doctors through
o Conflict can arise where there are traditional healers who practice medicine based on
local understanding of disease categories based on supernatural and spiritual things.
¾ Uses of health data: health services planning, detecting outbreaks, monitoring and complying
with IH regulations, estimate budgets and future needs, for international sharing and
comparison purposes
o The primary use is to track trends in populations health status at different levels (it can
be compared and used to evaluate the success or failure of programs and policies)
o This has led to the development of health impact assessment (HIA) which deal with the
health impact of public and private sector policies in arenas like zoning, transportation,
labor, energy, education, etc
¾ Monitoring diseases and complying with international health regulations
o According to the WHO constitution member states must report annually the actions
take to improve the health of their people (laws, regulation, reports stats, etc) and
notify the WHO cases and outbreak of certain disease.
The International Sanitary Regulations were established by WHO in 1951 and
later expanded under the IHR - International Health Regulation (?) in 1969.
With the reemergence of the plague, cholera and SARS IHR was amended to so
the WHO had to notified in 24hours in the event of any occurrence that
constitutes of a public health emergency; that is anything that poses a health
risk to other states and requires a coordinated international response
¾ Limitations of Health Data
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o One has to be cautious when interpreting health related because sometimes figures are
distorted (sometimes data is intentionally overestimated or underestimated reflecting
varied incentives to present information a certain way), figures can be biased
¾ 5 basic types of health data
o Population data: number of people in a population and their demographics (age, sex,
ethnicity, etc)
o Vital statistics: birth and death based on demographics
o Health statistics: morbidity by type, severity and outcome of illness or accident
o Health services statistics: numbers and types of facilities/services, distribution,
o Data on social inequalities in health: social factors that lead to inequalities (e.g.
poverty, education, occupational conditions, and population groups categorized by
class, race, ethnicity, etc)
¾ Population Data: this is obtained through enumeration (e.g. census t very costly), registration
(collecting vital statistics
o features of nation population census:
sponsorship t (legal administrative machiiner to sensure compliance and
defined territory t national and subnational territorial divisions made clear
universiality t inclusion of all physical present or living in the territory
individual enumeration tcollection of information individually or by household
simultaneity and specified time t collected at he same time
periodicity t conducted at regular intervals
compliation and publication t data put into useful form and published
¾ Determinants of Health: daily living conditions and social policies t physical and social
environment, working conditions, personal health characteristics, health care, social protection;
structural forces t gender (norms, economic participation), race/religion/immigrant status,
social inequalities (exclusion, income distribution, education), sociopolitical context
(participation, civil rights, violence levels, employment condition)
¾ Limits on Census data
o Diversity in a country (language barriers, level of literacy existence of nomadic people t
there are always ppl missed in census like homeless), lack of finances or available
human resources to conduct survey
o Some categories are not universal ethnicity and marital status, age differs in some
o Divisions based on race derive from classifications made in the 19th century used to
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used to predetermine conclusions and how to address them.
E.g. the South African Apartheid racial classifications were used by all public
agency to enforce differential treatment by law
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