ABSTRACT
Introduction: Numerous health indicators from different domains and comprehensive systems for describing health of community at state or district level are in vogue. Some sub-district information is also available from Health Management Information System but the numbers of indicators are many. Here composite health index of sub-district level is calculated similar to documented procedure. Objective: To develop block wise composite health index in an average district, Yavatmal district using available data. Methods: We grouped health indicators in following four categories; health outcomes, health system, other determinants and utilization of services. From these categories we selected four, three, two and one indicator respectively. Almost all the information is collected from already available data. There are 16 blocks in Yavatmal district. Block wise information of all indicators was first compiled. The block having best value was given 100 marks and remaining blocks were given proportionately less marks. The block wise total marks were calculated. The total score was converted into index by dividing by 1,000. Results: The composite health index ranged from 0.369 to 0.794. The median was 0.425 and interquartile range was 0.126. Out of ten, nine health indicators had normal distribution. We observed positive correlation between urbanization and composite health index. The Yavatmal block obtained highest composite index 0.794 and was an outlier. Principal component analysis extracted four components which contributed 82.06% to total variance. Conclusion: Using only ten indicators and simple method blocks composite health index can be developed which may be used to compare blocks or even districts.
ABSTRACT
Background: The National Health Mission expects bottom-up approach for preparing Project Implementation Plan and also expects special attention toward tribal areas. Some district-level health information is available from national health surveys, but subdistrict-level information is mostly not available. Gadchiroli is the farthest district from the state capital. There are 12 blocks in the district. It is a notified tribal district having 8.61%�.50% tribal population in different blocks and block-wise urbanization varies from 0.00% to 37.10%. Objectives: The objective was to assess community health status at block level in Gadchiroli district and then develop comprehensive health index for ranking the blocks. Methods: The author has used available secondary data sources including Census, Survey of Cause of Death scheme, health management information system, Directorate of Economics and Statistics, and Maharashtra Medical Council. Ten indicators were selected after discussion with public health specialists to evolve comprehensive health index. Blocks having best statistic in each indicator were given 100 marks and other blocks were given proportionate marks. Thus, the highest possible score for any block was 1000. Results: The range of block-wise score was from 424 to 781. The highest scoring block was Gadchiroli and was an outlier. The comprehensive score was having correlation with urbanization, r = 0.63 (95% confidence limits, 0.09�88). After principal component analysis, the extracted three components were responsible for most of the variations. Conclusions: Reasonably reliable and valid block-wise data are available to carry out community health assessment and develop comprehensive health index. The index is useful for comparison among blocks.