1. Manish Chaudhary MPH( BPKIHS) manish264@gmail.com
Sources of Data
Manish Chaudhary
MPH( BPKIHS)

2. Different sources of data
Census
Registration of vital events
Notification of diseases
Hospital records
Disease registers
Epidemiological surveillance
Environmental health data
Health manpower statistics
Population surveys
Other health service records

3. Census
A census is defined by the UN as “ the total process of collecting, compiling and publishing demographic, economic and social data pertaining at a specific time or times, to all persons in the country or delimited territory.”
It is usually done once in every 10 years at regular intervals by every country.
Recent census in Nepal is conducted in 2011.

4. Census
A census contains information on subjects not only demographic but also social and economic characteristics, conditions under which they live, how they work, their income and basic information.
Census provide basic data needed to compute vital statistical rates and other health, demographic and socio economic indicators.

5. Limitations of Census
It needs considerable organization, a vast preparation and long time to analyze the results
Full results are not available quickly.

6. Registration of vital events
Registration of vital events( birth, deaths, marriage) keeps a continuous check on demographic changes.
If registration of vital events is complete and accurate it can serve as a reliable source of health information.
Vital events: births, foetal deaths, marriages, divorces, adoptions etc

7. Registration of vital events
Limitations
Registration system in Nepal is unreliable, the data being grossly deficient in regard to accuracy, timeliness, completeness and coverage because of illiteracy, ignorance and lack of concern and motivation.

8. Notification of Diseases
Reporting of certain diseases or other health related conditions by a specific group, as specified by law, regulation, or agreement

9. Notification of Diseases
Disease or hazard-specific notifications
Communicable diseases
World Health Organization: International health regulations require reporting of cholera, plague, and yellow fever
Nepal: Polio, Measles, Hepatitis B, Malaria, Kala-azar, Japanese Encephalitis

10. Notification of Diseases
Chemical and physical hazards in the environment
Childhood lead poisoning
Occupational hazards
Firearm-related injury
Consumer product-related injury
Notifications related to treatment administration
Adverse effect of drugs or medical products
Adverse effect from vaccines

11. Notification of Diseases
Notifications related to persons at risk
Elevated blood lead among adults
Elevated blood lead among children
Limitations:
Notification covers only part of total sickness in the community.
System suffers good deal of under reporting.
Many atypical and subclinical cases escape notification due to non recognition.

12. Hospital Records A hospital record serves as
Geographic sources of patients
Age and sex distribution of disease and duration of hospital stay
Association between different diseases
The period between onset of disease and hospital admission
Cost of hospital care

13. Hospital Records
Hospital data constitute a basic and primary source of information about diseases prevalent in the community.
Limitations:
They constitute only the tip of an iceberg,
population at risk can not be defined.

14. Disease Registers
A register requires that permanent record be established, that cases be followed up, and that basic statistical tabulations be prepared both on frequency and on survival.
Patients on registers should be frequently be subjects of special studies.
Morbidity registers exists only for certain diseases stroke, myocardial infarction, cancer, congenital defects, tuberculosis and leprosy.
Limitation:
Coverage is not national or representative basis

15. Epidemiological surveillance
Special disease control/elimination program have been instituted for particular endemic diseases e.g malaria, JE, kala-azar etc.
Surveillance system are set up to report on the occurrence of new cases and on efforts to control the disease.
Limitations:
Surveillance system does not cover all diseases.

16. Environmental Health data
Environmental data can be helpful in the identification and quantification of factors causative of disease.
Multiple qualitative and quantitative approaches are used to monitor the environment, depending on the problem, setting, and planned use of the monitoring data.
Monitor air pollutants
Cities and towns monitor public water supplies for bacterial and chemical contaminants

17. Environmental Health data
Health agencies monitor animal and insect vectors for the presence of viruses and parasites that are harmful to humans
Departments of transportation monitor roads, highways, and bridges to ensure that they are safe for traffic; they also monitor traffic to ensure that speed limits and other traffic laws are observed
Occupational health authorities monitor noise levels in the workplace to prevent hearing loss among employees
Limitations
Environmental data are not aggregated

18. Health manpower Data
Health manpower data are available from their respective councils
Nepal Medical Council
Nepal Nursing Council
Nepal Health Professional Council
Nepal Pharmacy Council
Limitation:
Not all kinds of health manpower are registered
All health manpower are not registered

19. Population Surveys Structured and systematic gathering of information
Probably the most common method used for gathering information about populations
Designed to obtain specific information
Can be conducted once or on a periodic basis
Nepal Demographic and Health Survey
Nepal Micronutrient Status Survey

20. Other health service records
Demographic: Population density, movement, educational level
Economic: consumption of tobacco, dietary fats, sales of drugs and remedies, per capita income, employment and unemployment data
Social security: Medical insurance, disability benefit rate

21. Organizations as primary source of epidemiological data
Central Bureau of Statistics – Census
Ministry of Local Development and Ministry of Health and population- Health related data and vital statistics
Department of health services: annual report
WHO- notifiable disease
Epidemiology and Disease Control Division
Department of Drug Administration
Ministry of housing and physical planning
NHIECC, NGOs and INGOs

22. Thank You