COURSE: HEALTH STATISTICS

COURSE CODE: CHE 233

OBJECTIVES:

At the end of the course the students should be able to

1.0. Describe the nature, scope and uses of health statistics in the
health care system
2.0. Explain rates and ratio in relating to health statistics
3.0. Explain sampling techniques
4.0. Explain variables
5.0. Discuss the measures of central tendencies

UNIT: 1.0

 Instructional materials
- Pictures
- Computers

Teaching methods

 Demonstration
 Lecture

Types of Assessment

 Assignment
 Practical Assignment

At the end of the course the students should be able to

1.1. Define health statistics

1.2. List various sources of health statistics
1.3. Explain the importance of vital statistics

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1.1 Health is a state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity

Statistics is concerned with the technique by which information is collected

organized and analyzed and interpreted.

Health statistics: this is a systematic approach of obtaining, organizing and

analyzing health data to make comparison with previous years and to predict
future needs.

It includes all essential or vital statistical data that an individual can use to
make inferences to the population as far as health matters are concerned.

Vital statistics: define vital statistics as the application of statistical

principles to analyze and describe the vital events of life, birth, death,
morbidity, risk etc.

Vital statistics: these are data which gives quantitative information on vital
events occurring in life i.e marriages, births, marriages and death in a given
population

1.2 Sources of health statistics

1. Health Facilities: Hospital, clinics, maternities, dispensaries and

other health records centers are good sources of data on morbidity
and mortality rates, utilization of health care services as well as
efficiency of health facilities.
2. Notification of Disease - Some disease is of importance e.g
cholera, yellow fever, that international regulation, demands that
they should be reported to appropriate health department.
Notification of disease help to bring to the attention of appropriate

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 agency incidence of serious health problems that demands prompt
attention either to treat or control.
3. Surveys: Health surveys are usually used by international agencies
or federal ministry of health to find out prevalence of certain
conditions and practice.
4. Research Institute/Programme: Research institute or programme
relating to health or social services can provide data necessary for
health care planning, management and evaluation
5. School Health Record: School health services activities concerning
individual pupils, staff and the school must include medical, dental
examination, screening among others.
6. Vital Registration: Registration of birth, death, marriages are usually
carried out in hospitals, local government population offices and
other designated offices.

1.3 The importance of vital statistics:

1. Statistics assist the health worker in collecting, organizing summarizing,

interpreting and communicating information.

2. It enables each service unit to display statistical data on high priority

problems by using various ways of data presentation.

3. Health statistics help the policy maker in decision making based on the
information generated and analyzed.

4. Health statistical data help in the area of manpower and training so as

to correspond with the population demand.

5. Health statistics help towards the provision of medical and health

equipment and facilities that will enhance effective delivery of different
type of health services.

6. It helps to evaluate effectiveness of health services in a community

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7. It is used to study a specific health problems e.g maternal death rate,
still birth rate, prenatal mortality rate etc.

8. It assist to reflect the health status of a community or special group e.g

death rate gives or indicates the overall health condition of the
community.

STUDENTS ACTIVITY

Topic: Define health statistics, sources of health statistics and mention

some importance of health statistics

Learners outcome; the students can be able to define health statistics,

sources of health statistics and mention some importance of health
statistics
Task; list the sources of health statistics
Unit 2.0

 TOPIC: Rates and Ratio

 Instructional materials
- Pictures
- Standing order

Teaching methods

 Lecture
 Discussions and presentations

Types of assessment

 Assignment
 Quiz

Learning objectives

By the end of the lesson, the students will be able to;

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  Calculates different types of rates and ratios
 Describe the common measurements of rates and attack rates

Introduction

The concept of rates, ratios are very essential for understanding vital
statistics.

 Rates: this refers to the number of times an event did occur compared
with the number of times it could have occurred. It can also be the
number of people with specific characteristics divided by the number
of people. Rate has two element as
I. Numerator: this is the number of times an event could have
occurred
II. Denominator: this refers to the population of people in which the
vent could have occurred. It should be noted that a rate is
determined and it is expressed as 20 in 1000, 2 in 100, 10 in
100000 etc
 Ratio: it is a comparison of one thing to another e.g birth to death,
marriage to divorces. It is expressed as 2:100, 1:20, 1:100000 etc

Examples of ratios, rates, proportion

Ratios Rates (10,000) Proportions
1:100 100 in 10,000 1/100 = 0.01
3:10,000 30 in 10,000 3/100 = 0.03
4: 100,000 40 in 10,000 4/1000 = 0.004

2.1 Calculation of Different Types of Rate

Health statistics are expressed in rates i.e the number of events that are
related to the population involved. To simplify comparison, rates are usually
expressed in relation to an arbitrary total e.g 1000, 10,000, 1000,000.

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Crude Birth Rate

The crude birth rate (CBR) is equal to the number of live births (b) in a year
divided by the total midyear population (p), with the ratio multiplied by
1,000 to arrive at the number of births per 1,000 people

Number of lives birth in a define population during a given year x 1000

Number of population at mid-year of the same year

Sample Equation

For example, in 2007, there were 3,250 births in a city with population of
223,000. Therefore: CBR = (3,250 ÷ 223,000) X 1,000 or CBR = 14.57. So,
there were 14.57 births for every 1,000 people in the city.
Crude Death Rate

Number of death occurring in a define population during a given year x 1000

Number of population at the midpoint of the same year

Infant Mortality Rate

Number of death of children under one year of age occurring in a define

population during a given year x 1000

Number of live birth occurred in that population during the same year.

Neonatal Mortality Rate

Number of infant death under 28 days of age occurring in a defined

population during a given year x 1000

Number of life births occurring in that population during the same year

Maternal Mortality Rate

Number of death due to pregnancy and related causes occurring in a defined

population during a given year x 1000

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Number of birth (live +still birth) occurring in that population during the
same year

Fatality rates:

Number of death ascribe to a specific disease X 1000

Number of reported cases of a specified disease

Prevalence rates:

Number of persons who are sick at a given time X 1000

Average number of person exposed to risk

Life expectancy: This refers to the estimate of the average number of

additional years that a person of a given age can expect to live. Life
expectancy is a hypothetical measure. It assumes that the age-
specific death rates for the year in question will apply throughout the lifetime
of individuals born in that year. Therefore, life expectancy is commonly given
for specific categories, rather than for the population in general. For
example, the life expectancy for white females in the United States who
were born in 2003 is 80.4 years.

Life expectancy is calculated by constructing a life table. A life table

incorporates data on age-specific death rates for the population in question,
which requires enumeration data for the number of people, and the number
of deaths at each age for that population.

2.2. Rate Ratios. Rate ratios are closely related to risk ratios, but they
are computed as the ratio of the incidence rate in an exposed group divided
by the incidence rate in an unexposed (or less exposed) comparison group

Rate Ratio

Incidence rate in an exposed group

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Incidence rate in an unexposed (or less exposed)

Attack rate, in epidemiology, the proportion of people who become ill with
(or who die from) a disease in a population initially free of the disease.

Example1. The recorded numbers of birth and death in Rikadawa Health

clinic of Magama Local Government in the year 1995 are as follows

Live birth - 120

Death - 78

Assuming the mid-year pop is 20,000

Calculate the

A. Birth rate.

B. Death rate

Solution:

120 x 1000

20,000

= 6/1000

Death = 78 x 1000

20,000

= 4/1000

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2. The recorded No of women dying as a result of pregnancy, birth and
peuperium in the school clinic during the year 2000 is 10. The number of
birth in that facility is 200. Calculate the maternal moterlity rate

Solution:

10 x 100

200 = 5/100

STUDENTS ACTIVITY

Topic: Calculations of Rates and Ratios

Learners outcome; the students can be able to calculates different types of

rates

Task; Outline the formulas for calculating different types of rates

Unit 3.0

 TOPIC: sampling and sampling techniques

 Instructional materials
- Pictures
- Computers

Teaching methods

 Lecture
 Discussions and presentations

Types of assessment

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  Assignment
 Practical observation

Learning objectives

By the end of the lesson, the students will be able to;

 Define sampling
 Explain various types of sampling and their importance

3.1. Define sampling: sampling is the selection of a subset of individuals

from within a statistical population to estimate characteristics of the whole
population. Statisticians attempt for the samples to represent the population
in question.

Sampling is a process used in statistical analysis in which a predetermined

number of observations are taken from a larger population. The methodology
used to sample from a larger population depends on the type of analysis
being performed

This is a systematic process of choosing a fraction out of the total. It also

refers to the act of selecting a representative out of the entire population

3.2. The Importance of Sampling

 Sampling is important because it saves cost, this so because if all the

population are to be used it may consume a lot of resources both
human and materials

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  The use of sampling promote greater accuracy by limiting the use of all
enumerated population
 Sampling provides an excellent solution to information that is urgently
needed because data can be quickly collected, summarized and
analyzed appropriately
 It is a suitable method for infinite population. It is not possible to
examine all population of infinite or undefined population

Types of sampling

There two main method of sampling, that is probability and non-probability

sampling techniques

Probability Sampling Techniques

This refers to the process in which the law of probability determines which
elements of the population to include in the sample and they include

 Simple random sampling

 Stratified sampling
 Systematic sampling
 Cluster sampling

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Simple Random Sampling: This is a sampling procedure in which every
unit in the population has an equal chance of being selected in the sample. A
very popular method is the lottery method in which numbers are allocated to
sampling units, which are confined somewhere to avoid bias.

Systematic Sampling Techniques: This is a plan of ordered magnitude of

element within the population, it involves random selection of one element
from the first element and the selection of every element encountered
thereafter in a systematic way

Cluster Sampling: This is similar to stratified random sampling; stratified

random sample deals with individual selection, cluster sampling deals with
group selection. Element within a cluster are often physically close together,
that is, within the same geographical location and hence tend to possess
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similar characteristics. A simple random sample of clusters is then selected
after which all individual elements in each cluster is examined or studied

Stratified Sampling: this is a sampling design which involves selecting

some group of items from population based on classification and random
selection. It involves separating the population elements in to homogeneous,
non-overlapping and exhaustive groups called strata and then selecting a
simple random sample from each stratum

NON- PROBABILITY SAMPLING

This involves the use of criterion other than laws of probability in selecting
the items of the sample, for example the accessibility of the elements,
expert’s opinion or convenience to the researcher and they include

 Judgmental sampling
 Quota sampling
 Convenience sampling
Judgmental Sampling: This is non- random sampling procedure which
involves selection of the items in a sample on the basis of judgment or
opinion of one or more persons. It is usually employed when a random
sampling cannot be taken or is not practicable

Quota Sampling: This uses established guidelines to determine the

elements to be included in the sample, in most cases a prescribed limit is
specified as regards the number of element to be sampled from each of the
non- overlapping groups or categories

Convenience Sampling: This is the least representatives sampling

procedure which selects observations on the basis of convenience to the
researcher. An example of this is street - corner surveys in which the
researcher interview people as they go by

STUDENTS ACTIVITY

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Topic: Sampling and sampling techniques

Learners outcome; Define sampling and identify different types of

sampling and their importance

Task: List probability and non-probability sampling techniques

Unit 4.0

 TOPIC: Variables
 Instructional materials
- Pictures
- Charts

Teaching methods

 Lecture
 Discussions and presentations

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 Types of assessment

 Assignment
 Group work

Learning objectives

By the end of the lesson, the students will be able to;

 Define variables
 List the types of variables

4.1. Variables: These are characteristic that takes on different values in

different persons, place or things. A quantity that varies within limit such as
height, weight, blood pressure

Variable: A characteristic, number, or quantity that increases or decreases

over time, or takes different values in different situations.

4.2. Type of variables:

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Figure 1 Broad Classification of Variables

Common Types of Variables

 Qualitative variable: a broad category for any variable that can’t be

counted (i.e. has no numerical value). Nominal and ordinal variables fall
under this umbrella term.
 Quantitative variable: A broad category that includes any variable that
can be counted, or has a numerical value associated with it. Examples of
variables that fall into this category include discrete variables and ratio
variables.
 Categorical variable: variables than can be put into categories. For
example, the category “Toothpaste Brands” might contain the
variables Colgate and Aquafresh.
 Confounding variable: extra variables that have a hidden effect on
your experimental results.
 Continuous variable: a variable with infinite number of values, like
“time” or “weight”.
 Control variable: a factor in an experiment which must be held
constant. For example, in an experiment to determine whether light
makes plants grow faster, you would have to control for soil quality and
water.

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 Dependent variable: the outcome of an experiment. As you change the
independent variable, you watch what happens to the dependent
variable.
 Discrete variable: a variable that can only take on a certain number of
values. For example, “number of cars in a parking lot” is discrete
because a car park can only hold so many cars.
 Independent variable: a variable that is not affected by anything that
you, the researcher, do. Usually plotted on the x-axis.
 A measurement variable has a number associated with it. It’s an
“amount” of something, or a “number” of something.
 Nominal variable: another name for categorical variable.
 Ordinal variable: similar to a categorical variable, but there is a clear
order. For example, income levels of low, middle, and high could be
considered ordinal.

STUDENTS ACTIVITY

Topic: Variables

Learners outcome; the students can be able to define variables

Task; Outline different types of variables

Unit 5.0

 TOPIC: Measures of Central Tendency

 Instructional materials
- Pictures
- Calculators

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Teaching methods

 Lecture
 Discussions and presentations

Types of assessment

 Assignment
 Quiz

Learning objectives

By the end of the lesson, the students will be able to

 Define central tendency

 List, explain and compute the various measures of central tendency

5.1. Central Tendency

This is of how the data tends to a central value. It is a typical value such that
each individual value in the distribution tends to cluster around it.

It is an index used to the concentration of values near the middle of the

distribution

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5.2. Measures of Central Tendencies

 Mean
 Median
 Mode

The Mean – The mean is the most commonly used and also of the greatest
importance out of the three averages, there are various types of Mean. But
our concern is the arithmetic mean.

The arithmetic mean is the representative value of the series such that all
elements would obtain if the total were shared equally among them.
Arithmetic mean of a set of data is the sum of all the numbers in a set
divided by the number of observation.

Advantages

 It is very easy to calculate

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  It is useful for further statistical work
 It is a representative of all observations

a. The mean for ungrouped data

The formula = X = Σx where X = Mean

Σ = Summation

X – sum of observation

n = Total no of observation

Example

Example identify the mean in the following observation

1. 1,2,3,4,5,6,7,8,9
2. 2,1,3,3,4,5,6,7,8
Solution:

1. 1+2+3+4+5+6+7+8+9 = 45 = 5.0
9 9
2. 2+1+3+3+4+5+6+7+8 = 39 = 4.33
9 9

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b. The mean for data with multiple frequencies

X = Σfx

F= Frequency

X= Sum of observation

n= Total number of observation

Example: Calculate the mean in the table below showing monthly gain of
employees in Usmaniyya car wash

Monthly gain X NO Employees ( f) fX

5 4 20

10 7 70

15 3 45

20 5 100

25 1 25

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 Total 20 260

Solution

X= Σfx 260 = 13

n 20

The Median – The median for a set of data in an array is the value that
divide the data set into two equal halves, that is when these observations
are arranged in order of magnitude, half of them will be less than or equal to
the media, while the other half will be greater than or equal to it.

Advantages

 It is easy to find for a set of ungrouped data

 It is not influenced by an extreme value of a given set of data.
 It can be obtain graphically

Median of Ungrouped Data

- Arrange data in order of magnitude (increasing or decreasing order)

- Locate the middle value of data (if data is odd)

- If the data is even, add up two middle values and divide by two.

Example: Identify the median in the following observation

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3. 1,2,3,4,5,6,7,8,9
4. 2,1,3,3,4,5,6,7,8
5. 3,3,4,4,5,6,7,8,9,9
Solution:

1. 5 is the median ( considering the above guideline)

2. 4 is the median (1,2,3,3,4,5,6,7,8 arranged in order of magnitude)
3. Here 5 + 6 =11 = 5.5 is the median
2 2

The Mode – For any set of numbers, the mode is the observation which
occurs most frequently, mode could be one more than one if there is one
mode it is called unimodal, and if there are many mode it is multimodal.

Example identify the mode in the following observation

1 1, 2, 3, 4, 5, 6, 7, 8, 9

2 2, 1, 3, 3, 4, 5, 6, 7, 8

3 3, 3, 4, 4, 5, 6, 7, 8, 9

Solution

1. There is no mode

2. The mode is 3 that is unimodal

3. The mode is 3and 4 that is bimodal

STUDENTS ACTIVITY

Topic: Measures of Central Tendency

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Learners outcome; the students can be able to calculates the mean,
median and mode

Task: List the advantages and disadvantages of mean, median and mode

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