Selection of indicators
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Selection of Indicators. TOR of the Working Group. Objective of the WG on Indicator Selection. The overall objective is to: Decide on a list of proposed indicators to be included in the District Health Information System

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Selection of Indicators

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Selection of Indicators

TOR of the Working Group

Objective of the WG on Indicator Selection

  • The overall objective is to:

    • Decide on a list of proposed indicators to be included in the District Health Information System

    • Document the rationale for the indicator selection and the possible use of the indicator in health services management at district and facility (FLCF, hospitals) levels

Specific Activities of the Working Group

  • Functional Analysis of each level of district health service delivery management (existing/proposed, if any)

    • What actions manager at each level is supposed to take

  • Identifying specific information needs for performing those functions

    • Service delivery – monitoring current services and identifying health service needs

    • Resource management – resource allocation, monitoring use and identifying resource needs

    • Planning, monitoring

  • Selecting indicators that cater to the information needs of each level of health service delivery management

Steps in selecting indicators that cater to the information needs

  • Setting criteria for indicators selection

  • Listing down possible indicators

  • Selecting indicators as per agreed criteria

    • documenting rationale for selection

  • Defining the selected indicators

    • numerator and denominator

  • Defining data source & frequency of data collection for the selected indicators

  • Defining possible interpretation & use of the indicators

  • Setting benchmarks, targets or ranges for the indicators

Step 1: Setting Criteria for Indicator Selection (i)

  • Definition of Indicator

    • Indicator is a variable that evaluates status and permits measurement of changes over time.

      • An indicator does not always describe the situation in its entirety, but sometimes only gives an indication of what the situation might be and acts as a proxy

Step 1: Setting Criteria for Indicator Selection (ii)

  • Criteria for indicator selection

    • Relevance to:

      • Management objectives of facility or district managers

        • Measuring effectiveness (realization of organizational objectives) or efficiency (performance relative to resources at disposal) of services

        • Identifying service delivery management/resource gaps and needs

      • Provincial/federal government’s health priorities

        (What is the relative importance of the subject matter to be addressed and the decision to be made based on the indicator?)

Step 1: Setting Criteria for Indicator Selection (iii)

  • Criteria for indicator selection

    • Scientific validity

      • The indicator accurately measures the situation or phenomenon under investigation

    • Specificity

      • The indicator reflects changes only in the phenomenon concerned

    • Sensitivity

      • Changes shown in the indicator reflect a true change in the situation under study

Step 1: Setting Criteria for Indicator Selection (iv)

  • Criteria for indicator selection

    • Feasibility of measuring the indicator

      • Cost of capturing the data

        • Direct financial implications

        • Human resource and their capacity required for capturing and reporting the data

        • Time requirement

Indicators: Selection Process

Provide outpatient curative services

Diarrhea & Dysentery, especially in under 5 children

ARI/Pneumonia, especially in <5

Management of suspected/confirmed uncomplicated malaria cases

Primary care of diabetes/hypertension cases

Care of minor ailments

Refer complicated cases, suspected TB cases

Primary treatment of injury

Primary care of mental disorders (?), malnutrition (?)

Provide child health care

EPI vaccination

Treatment of diarrhea, ARI

Provide Reproductive Health care

Antenatal and postnatal checkup

TT immunization

Attend deliveries (at home or facility, by LHV)

FP services – sales of FP commodities

Treatment of RTI/STIs

Referral of complicated cases

Treatment of anemia in CBAs

Provide early warning of infectious diseases epidemics

Measles, NNT, viral hepatitis, hemorrhagic fevers, diarrheal diseases, etc.

Basic Health Unit (BHU) - Functions (Services):

Basic Health Unit (BHU) - Functions (Services):Information needs

  • Overall performance (output) of the facility

    • Patient load

      • Total

      • Certain specific diseases/conditions

      • Top diseases/conditions

      • Gender-wise

    • Coverage of child care, maternal care

    • Referrals – overall, maternal health, disease specific

  • Early warning of epidemics

Logistics management


Other consumable items


Financial (none)

Staff management

Attendance, Leave


Information needs

Resource availability/ requirements

Yearly inventory, status

Monthly stock-out

Adequacy of resources vis-à-vis performance

BHU: Management Functions

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