Problem Summary

Ms. Zoobaidah, a 45-year-old administrative assistant consulted her family

physician because of her weight gain and changes in her body shape. Due to a
deterioration in her marital relationship, she had tried to lose weight including the
use of different diets and herbal supplements without any success.
She complained of heartburn (pyrosis) and a feeling of regurgitation. General
physical examination showed an obese woman without Cushingoid features. Her
abdomen was found to be flabby with white striae and an old cholecystectomy scar.
Nervous system and thyroid examinations were essentially normal.
She was diagnosed with obesity and gastroesophageal reflux disease (GERD). She
was placed on proton pump inhibitors but returned two years later with symptoms
suggestive of erosive oesophagitis, which was confirmed during endoscopic
examination. She was advised to lose weight and avoid dietary triggers and to
consider bariatric surgery if all other options to lose weight fails.
 Learning objectives

01 02 03 04
Describe the Define Health; Explain different Describe the use of
epidemiology of differentiate between health indicators that databases and Health
obesity and individual and influence population Information Systems
gastroesophageal population health health to monitor and
reflux disease in advance healthcare
Qatar and worldwide
E FF E C T I V E HE A LT H M O NI T O R I NG T H R O U GH R O B U S T , S T A ND A R D I Z E D I N D IC A T O RS IS
E S S E NT IA L F O R D R I V I NG P RO G R ES S T O W A R D S B E T T ER HE A LT H O U T C O M E S .
Purpose

• GU ID E M O N IT O RIN G O F HEALT H • IM P RO VE D AT A AVAILAB ILIT Y AN D

R ES U LT S Q U ALIT Y
Provide a framework to track progress on health Ensure reliable and comprehensive data on health
outcomes and indicators at national and global levels. results is accessible.

• R ED U CE EX CES SI VE REPO RT IN G • EN H ANC E T RAN S PAR EN CY AN D

R EQ U I RE MEN T S ACC O U N T AB ILIT Y
Streamline data collection and reporting processes to Provide a framework for countries to track progress and
minimize burden on countries. demonstrate their commitment to health goals.

• EN H ANC E EF F ICI ENC Y O F D AT A

IN VE ST M EN T S
Optimize the use of resources for data collection,
analysis, and utilization.
• Feasibility • Timeliness

• Validity • Replicability

• Relevance • Sustainability
 Subdomains Numerator Databases
•Adult mortality rate •Population alive at
between 15 and 60 exact age 15 in the
years of age •Number of deaths synthetic life table •Civil or sample
between ages 15 population. registration
years and 60 years in •Census
the synthetic life •Census or surveys
table population
Domains Indicators Denominator
Subdomains

Health Status Risk Factors Service coverage Health systems

• Mortality by age and sex • Nutrition • Reproductive, maternal, • Quality and safety of
• Mortality by cause • Infections newborn, child and care
• Fertility • Environmental risk adolescent • Utilization and access
• Morbidity factors • Immunization • Health workforce
• Noncommunicable • HIV / TB • Health information
diseases • Tuberculosis • Health financing
• Injuries/harmful • Malaria • Health security
traditional practices • Neglected tropical • Governance
diseases
• Screening and preventive
care
• Mental health
• Substance abuse
• Essential health services
Different type of Data sources, health indicators and example

Data base Health Indicators Examples

Civil registration Death rate civil registration system in Qatar
and vital statistics Birth rate is centralized and according to
Systems the law No. 5 and the following
amendments, the Qatar National
Health Authority
Population-based health Health status depending on the The Demographic and Health
surveys focus of interest Surveys (DHS) Program
https://dhsprogram.com/
Hospital based/ health facility Health status depending on the Qatar National E-Health & Data
assessments and surveys focus of interest Program (QNeDP)
Administrative data source human resources, Finances, Department of Healthcare
Logistics Professions (DHP), one of the
departments of the Ministry of
Public Health
Modelling Health status depending on the Chapter 5: modelling - GOV.UK
focus of interest (www.gov.uk)
The resources required to The immediate, tangible The changes or The long-term,
carry out activities, such as products or services benefits that result sustainable changes or
funding, staff, equipment, resulting from the from the outputs effects that occur as a
and materials. activities result of the outcomes.

IMPACT
INDICATORS
Health Indicators in Practice
Inputs and Processes

Health Financing Health Workforce Health Infrastructure Health Information

Allocation of funding for Development and distribution of Availability and accessibility of Collection and reporting of health
healthcare, including total healthcare workers, including healthcare facilities and data, including birth and death
expenditure, government training and output from equipment, such as hospital bed registration, and facility-level
spending, external funding, and educational institutions. density and service access. reporting.
out-of-pocket payments.

These key inputs and processes are essential for building a strong and
effective healthcare system to achieve desired health goals.
Outputs

• Number of Trained Health Workers • Improved Healthcare Facilities

• Availability of Medical Equipment

• Increased Service Utilization
Impacts

Reduction in Under-Five Mortality Rate

Increase in Average Life Expectancy at Birth

Decrease in Maternal Mortality

Ratio

Reduction in Malaria Incidence

Rate
Exercise 1
• What data and indicator would you like to measure now and over
time for this particular case?
• What data and indicator would you like to measure to understand
population level trend of the disease or risk factor in the question?
• How would you measure such an indicator a individual level and
at population level?
• How would you present information of such an indicator at
individual and population level?
Measuring Obesity
• Overweight and obesity are defined
as abnormal or excessive fat
accumulation that may impair
health.
• Can be measured by body mass
index (BMI) scale.
• Body Mass Index (BMI) is defined as
the weight in kilograms divided by the
square of the height in metres
(kg/m2).
• For example, an adult who weighs 70kg
and whose height is 1.75m will have a
BMI of 22.9.
Source: https://ourworldindata.org/obesity
Relationship between indicators
• Energy imbalance between
calories consumed and calories
expended.
• Globally, there has been:
• an increased intake of energy-
dense foods that are high in fat and
sugars; and
• an decrease in physical inactivity
due to the increasingly sedentary
nature of many forms of work,
changing modes of transportation,
and increasing urbanization.
Burden of Obesity
• 8% of global deaths were attributed to obesity in 2017.
• There are large differences – 10-fold – in death rates from obesity
across the world.
• 13% of adults in the world are obese.
• 39% of adults in the world are overweight.
• One-in-five children and adolescents, globally, are overweight.
Thank You