Core Health Data for the Americas

Glossary

A1: Population


• All the inhabitants of a country, territory or area. In demographic terms it is the number of inhabitants that actually live within the border limits of the country, territory or area. The mid-year population refers to the actual population at July 1st.
• Unit of measure: Thousands

A2: Life expectancy at birth (LEB)


• The number of years, on average, that a live birth in a given population and year can expect to live, if the age-specific mortality prevailing at its birth remains constant. Calculated as the total number of years that a given birth cohort can be expected to live if these mortality rates (numerator) continue to apply, divided by the number of children in the cohort (denominator).
• Unit of measure: Years

A3: Total fertility rate (TFR)


• The average number of children that would be born to a woman or a group of women if all lived to the end of their childbearing years and bore children according to a given set of age-specific fertility rates, such as those for a given year/period and country. Usually referring to women aged 15 to 44 or 15 to 49, it is calculated by adding the age-specific fertility rates for all the ages considered and multiplying by the interval, into which the ages are grouped, which is usually 5 years.
• Unit of measure: Children per woman

A4: Annual rate of population growth


• The ratio between the annual increase in the population and the total population for that year, usually multiplied by 100. The annual increase (numerator) is calculated as (births less deaths) + (immigrants less emigrants) divided by the total population (denominator) estimated at mid-year. However, due to the unavailability of data, usually it is calculated using the change between two censuses.
• Unit of measure: Percent

A5: Urban population


• The term "urban" refers essentially to cities, towns, and other densely populated areas. However, operational definitions may vary among countries, since the criteria used in the countries may be different: populated centers of 2,000 or 2,500 inhabitants and more, municipal seats or headquarters, populated centers that have certain basic services, etc.
• Unit of measure: Percent

A6: Number of registered births


• Total number of like births registered in the civil registration for a specific year.
• Unit of measure: Births

A7: Crude birth rate


• The ratio, in a given year, between the number of live births in a population and the number of residents in that population. The numerator is the number of births during the year and the denominator, the size of the population (usually estimated at mid-year) where those births occurred. This quotient is usually multiplied by 1,000.
• Unit of measure: Per 1,000 population

A8: Number of registered deaths


• Total number of deaths registered in a specific year.
• Unit of measure: Deaths

A9: Percent of population under 15 year of age


• The percentage that represents the population of youngsters under 15 years of age from the total population.
• Unit of measure: Percent

A10: Percent of population 65 years of age and over


• The percentage that represents the population 65 years of age and over from the total population.
• Unit of measure: Percent

B1: Calories available (Kcal/day per capita)


• The energy content of the diet expressed through the supply of dietary energy per capita. Calculated according to the availability of the various types of food (grains, tubers, vegetables, milk, sugar, meat, etc.) for human consumption. Each type is converted into kilocalories (numerator) and divided by the total person-days--that is, the product of the total population multiplied by 365 (denominator). It is usually calculated for a period of more than 1 year.
• Unit of measure: Kcal x day per capita

B2: Adult literacy rate


• Percentage of the population 15 years and over that can read and write. In some cases the cut-off age may be different.
• Unit of measure: Percent

B3: Average years of schooling of the population


• The average number of years of studies that the members of a population have had. A more easily calculated proxy is the combined enrollment of the primary, secondary, and tertiary educational levels. This indicator would measure the average number of years of study that a child at the entry age of the educational cycle would have in a given year if the primary, secondary, and tertiary enrollments remained the same as those of the reference year. This is a complementary indicator of the literacy rate, since it measures the current situation and its future impact, while the literacy rate measures the cumulative situation.
• Unit of measure: Years

B4: Gross Domestic Product (GDP) per capita


• The GDP measures the total value of a country's output of goods and services for final use, independent of their domestic and external origin, produced by residents and nonresidents alike.
• Unit of measure: Dollars per capita

B5: Gross domestic product/capita, US$ adjusted for purchasing power parity (PPP)


• This is an indicator of the GDP that is being used within the framework of the UN International Comparison Program, which facilitates international comparisons, using the purchasing power parity of the currency (PPP) instead of the exchange rate as a conversion factor.
• It is defined as the number of monetary units of a country that is needed to buy the same amount of goods and services in the national market that would se able to be purchased with one US dollar in the United States of America.
• Unit of measure: Dollars per capita

B6: Ratio of highest 20% income/ lowest 20% income


• Measures inequalities in the distribution of household income in a given year or period. The numerator is the cumulative income corresponding to the 20% of households with the highest income, and the denominator the cumulative income of the 20% of households with the lowest income. A complementary indicator can be obtained by measuring the wealth, instead of the income, of the households, which would represent the cumulative situation.

B7: Percent of population living in poverty


• The definition of poverty used in Latin America by ECLAC uses the income method, which is based on the calculation of poverty lines. These represent the amount of income required by each household to meet the basic needs of all its members. The poverty line is based on an estimate of the cost of a basic food basket that covers the nutritional needs of the population, taking into account its consumption habits, as well as the actual availability of food in the country and its relative prices. The value of this basket is combined with an estimate of the resources required by households to meet basic nondietary needs. Definition of the extreme poverty line considers only the cost of the food basket.
• The number of households living in poverty and the total number of households are used to estimate the population living in poverty. In many cases what is actually calculated is the percentage of households, and not the population, living in poverty. Although the ultimate objective--the measurement of poverty--is the same, the figures for the different countries are not strictly comparable, since different operational definitions are used: the content of the food basket, adjusted by relative prices according to geographical area, consumption habits, components of the basic nondietary needs, etc. Despite the lack of strict comparability, the values obtained can be used to monitor a country's situation and make general comparisons, with due caution and consideration of the methods of calculation.
• Unit of measure: Percent

B8: Percent of population living in extreme poverty


• The definition of poverty used in Latin America by ECLAC uses the income method, which is based on the calculation of poverty lines. These represent the amount of income required by each household to meet the basic needs of all its members. The extreme poverty line is based on an estimate of the cost of a basic food basket that covers the nutritional needs of the population, taking into account its consumption habits, as well as the actual availability of food in the country and its relative prices.
• The number of households living in extreme poverty and the total number of households are used to estimate the population living in extreme poverty. In many cases what is actually calculated is the percentage of households, and not the population, living in extreme poverty. Although the ultimate objective--the measurement of extreme poverty--is the same, the figures for the different countries are not strictly comparable, since different operational definitions are used: the content of the food basket, adjusted by relative prices according to geographical area, consumption habits, etc. Despite the lack of strict comparability, the values obtained can be used to monitor a country's situation and make general comparisons, with due caution and consideration of the methods of calculation.
• Unit of measure: Percent

B9: Unemployment rate


• The term "unemployed" is applied to every person over a given age who, during the reference period, was without work (paid employment or self-employment), while available to work or having taken concrete steps to find work. Calculated as the number of unemployed people (numerator), divided by the size of the economically active population (EAP) (denominator), multiplied by 100. The age cut-off may differ from country to country. The reference period may also vary. Rates are usually calculated for periods less than one year, with an annual average estimated on the basis of the values of the shorter periods.
• The EAP is also known as the work force. All people who are working or unemployed during the reference period (one week, one day, etc.) are included. Every person over a specific age is considered to be employed if he fits into one of the following categories: has paid employment (in currency or in kind); is self-employed; works in a family business; is not working temporarily for a particular reason, but will return to work once the situation has returned to normal.
• Unit of measure: Percent

B10: Inflation: Consumer price index


• Generally represents the variation of the cost, relative to the base period, of a typical basket of goods and services actually acquired by a representative group of consumers.
• Unit of measure: Percent

C1: Infant mortality rate


• The ratio of the number of deaths in children under 1 year of age in a given year to the number of live births in that year. Calculated as the number of children born alive in a given year that died before the age 1 (numerator), divided by the total live births during that same year (denominator), multiplied by 1,000.
• Unit of measure: Per 1,000 live births

C2: Neonatal mortality rate


• In a given year, quotient between the number of children born alive that died before the age of 28 days (numerator) and the total number of live births (denominator) in that same year, multiplied by 1,000. It shows the absolute risk of dying in the first 27 days of life.
• Unit of measure: Per 1,000 live births

C3: Postneonatal mortality rate


• In a given year, quotient between the number of children that were alive after 27 days of age and died before the age of 1 year (numerator) and the total number of live births (denominator) in that same year, multiplied by 1,000. It shows the absolute risk of dying between the 28th and the 364th days of life.
• Unit of measure: Per 1,000 live births

C4: Perinatal mortality rate


• In a given year, quotient between the sum of the number of late fetal deaths (28 or more completed weeks of pregnancy according to the ICD-9, or 22 or more completed weeks of pregnancy according to the ICD-10) plus the number of early neonatal deaths (less than 7 days of age) (numerator) and the number of live births (denominator) in that same year, multiplied by 1,000. It shows the absolute risk of dying in the perinatal period.
• Unit of measure: Per 1,000 live births

C5: Estimated death rates


• The ratio, in a given year, between the number of deaths in a population and the number of residents in that population. Calculated as the number of deaths (numerator), divided by the population, estimated at mid-year (denominator), multiplied by 1,000.
• Unit of measure: Per 100,000 population

C6: Mortality rate under age 5 (UNICEF)


• The ratio between the number of deaths in children under 5 in a given year and the number of live births in that year. Calculated as the number of children who die before reaching 5 years of age (numerator), divided by the total number of live births in the given 1-year period (denominator), multiplied by 1,000. This is an approximation of the probability of dying before the age of 5.
• Unit of measure: Per 1,000 live births

C7: Proportion of the infant mortality due to conditions originating in the perinatal period


• A component of the infant mortality rate, obtained by limiting the deaths in children under 1 year to deaths from the causes included in Chapter XV of the ICD-9 (codes 760 to 779) or Chapter XVI of the ICD-10 (codes P00-P96).
• Unit of measure: Percent

C8: Number of registered deaths due to measles in children under 5 per year


• Number of deaths in children under 5 years of age whose death certificates register measles as the underlying cause of death (Code 055 of the ICD-9 and Code B05 of the ICD-10).
• Unit of measure: Deaths

C9: Number of registered deaths due to other vaccine-preventable diseases (diphtheria, whooping cough, tetanus, and polio) in children under 5 per year


• Total number of deaths of children under 5 years of age whose death certificates register diphtheria, whooping cough, tetanus or polio (codes 032,033,037,045 of the ICD-9 and codes A33, A34, A35, A36, A37, and A80 of the ICD-10) as the underlying cause of death, in a specific year.
• Unit of measure: Deaths

C10: Estimated death rates due to intestinal infectious diseases in children under 5 years of age


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to intestinal infectious diseases (codes 001-009 of the ICD-9 and A00-A09 of the ICD-10) in children under 5 years of age, and the population of children under 5 years of age, multiplied by 100.000.
• Unit of measure: By 100,000 population

C11: Estimated death rates due to acute respiratory infections in children under 5 years of age


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to acute respiratory infections (codes 460-466, 480-487 of the ICD-9 and J00-J22 of the ICD-10) in children under 5 years of age, and the population of children under 5 years of age, multiplied by 100.000.
• Unit of measure: By 100,000 population

C12: Number of registered deaths due to tetanus neonatorum for the year specified


• Total number of deaths for a specified year whose death certificates register tetanus neonatorum (Code 771.3 of t he ICD 9 and A033 of the ICD 10) as the underlying cause of death.
• Unit of measure: Deaths

C13: Maternal mortality rate


• In a given year, quotient between the number of maternal deaths (numerator) and the number of live births (denominator) in that same year, multiplied by 1,000. Maternal death is the death of a woman while pregnant or within the 42 days after termination of that pregnancy, regardless of the length and site of the pregnancy, due to complications of pregnancy, delivery, and puerperium (i.e., any cause related to or aggravated by the pregnancy itself or its care; ICD-9 codes 630-676 or ICD-10 codes O00-O99), but not due to accidental or incidental causes.
• The late maternal mortality is the mortality that is due to complications of pregnancy, delivery, and puerperium that occurred between 42 and 364 days after the termination of the pregnancy.
• Unit of measure: By 100,000 live births

C14: Estimated death rates due to communicable diseases


• The causes of death grouped under this heading correspond to Chapter I: Certain infectious and parasitic diseases, of the ICD-9 and ICD-10, plus those included under the heading ARI (Acute Respiratory Infections), meningococcal infections and meningitis. Of particular importance are:
  • Intestinal infectious diseases (Diarrhea, 001-009 in ICD-9 and A00-A09 in ICD-10);
  • Tuberculosis (010-018 in ICD-9 and A15-A19 in ICD-10);
  • Certain vaccine-preventable diseases: diphtheria, whooping cough, tetanus, polio, measles (032, 033, 037, 045, 055 in ICD-9 and A33, A34, A35, A36, A37, A80, B05 in ICD-10);
  • Acute respiratory infections (ARI) (460-466, 480-487 in ICD-9 and J00-J22 in ICD-10);
  • Meningococcal infections (036 in ICD 9 and A39 in ICD 10). NOTE: the category "communicable diseases" in the 6/61 list, does not include meningococcal infections;
  • Meningitis (320-322 in the ICD 9 and G00-G04 in ICD 10).
• Unit of measure: By 100,000 population.

C15: Number of registered deaths from tuberculosis for the year


• It is the number of registered deaths due to tuberculosis as an underlying cause (codes 010-018 of the ICD 9 and codes A15-A19 of the ICD 10).
• Unit of measure: Deaths

C16: Number of registered deaths from AIDS for the year


• It is the number of registered deaths due to AIDS as an underlying cause (codes 279.1, 279.5 and 279.6 of the ICD 9 and B20-B24 of the ICD 10).
• Unit of measure: Deaths

C17: Estimated death rates due to diseases of the circulatory system


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to diseases of the circulatory system, Chapter VIII of the ICD 9 (Codes 390-459) or Chapter IX of the ICD 10 (Codes I00-I99), and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C18: Estimated death rates due to ischemic heart disease


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to ischemic heart disease (410-414 in ICD-9, I20-I25 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C19: Estimated death rates due to cerebrovascular disease


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to cerebrovascular diseases (430-438 in ICD-9, I60-I69 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C20: Estimated death rates due to tumors


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to tumors -malignant neoplasms, Chapter II of the ICD-9 (codes 140-239) or to Chapter II of the ICD-10 (codes C00-D48) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C21: Estimated death rates due to malignant neoplasms of the lung, trachea, and bronchus


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Malignant neoplasms of the lung, trachea, and bronchus (162 in ICD-9, C33-C34 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C22: Estimated death rates due to malignant neoplasms of uterus


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Malignant neoplasms of uterus (179, 180, 182 in ICD-9, C53- C55 of the ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C23: Estimated death rates due to malignant neoplasms of the breast


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Malignant neoplasms of the breast (174 in ICD-9, C50 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C24: Estimated death rates due to malignant neoplasms of digestive organs


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Malignant neoplasms of digestive organs (150-159 in ICD-9, C15-C26 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C25: Estimated death rates due to External causes


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to the causes of death corresponding to the Supplementary Classification of External Causes of Injuries and Poisonings of the ICD-9 (codes E800-E999) or to Chapter XX of the ICD-10 (codes V01-Y89) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C26: Estimated death rates due to accidents, excluding transport


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Accidents, excluding transport (codes E850-E949 in ICD-9, W00-X59 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C27: Estimated death rates due to transport accidents


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Transport accidents (codes E800-E848 in ICD-9, V01-V99 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C28: Estimated death rates due to suicide and purposely self-inflicted injuries


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Suicide and purposely self-inflicted injuries (E950-E959 in ICD-9, X60-X84 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C29: Estimated death rates due to homicides, injury due to legal intervention or war operations


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Homicides, injury due to legal intervention or war operations (E960-E978, E990-E999 in ICD-9, X85-Y09, Y35,Y36 in ICD-10) and the population of the sex and age groups specified, multiplied by 100.000.

C30: Estimated death rates due to Cirrhosis and chronic liver disease


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Cirrhosis and chronic liver disease, codes 571 of the ICD 9 and codes K70, K73, K74, K76 of the ICD 10. and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

C31: Estimated death rates due to Diabetes mellitus


• It is the quotient for a specific year between the number of estimated deaths (estimation method recommended was published in Health Statistics from the Americas-1992, PAHO/WHO, Scientific Publication No. 542) due to Diabetes mellitus, codes 250 of the ICD 9 and codes E10-E14 of the ICD 10 and the population of the sex and age groups specified, multiplied by 100.000.
• Unit of measure: By 100,000 population

D1: Birthweight


• The first measurement of the weight of the fetus or newborn made at the time of birth or in the first hours of life, before the significant postnatal weight loss. The most commonly used indicator of low birthweight is a weight of under 2,500 grams (Low Birthweight). Another complementary indicator is a weight of under 1,500 grams (Very Low Birthweight).
• Unit of measure: Kilograms

D2: Proportion of children under 5 years of age with weight for age (W/A) less than 2 standard deviations (-2SD) from the reference median (moderate and severe deficit)


• A measure of the nutritional status of children. A child is considered to be underweight for its age if its weight is lower than the value obtained by subtracting two standard deviations from the median of the reference population. The median and standard deviation are those corresponding to the distribution of weight frequencies of a healthy child population of that age and sex. For these purposes, the distribution of a reference population recommended by WHO is used, based on data from the U.S. National Center for Health Statistics. There is a table with reference values for every month of age up to 5, by sex. The influence of genetic or ethnic factors in that age group is considered to be insignificant.
• Unit of measure: Percent

D3: Percent of infants exclusively breast-fed through 120 days of age


• The proportion of children who, from birth until the end of the fourth month of life (120 days of age), are fed exclusively breast milk.
• Unit of measure: Percent

D4: Average number of decayed, filled or missing teeth at age 12


• The average number of teeth found decayed, filled or missing in children at age 12 years.
• Unit of measure: Teeth

D5: Number of confirmed cases of poliomyelitis registered during the year


• Number of poliomyelitis cases confirmed by laboratory in a specific year.
• Unit of measure: Cases

D6: Number of measles cases registered during the year among children <5 years of age


• Number of measles cases confirmed by laboratory, in children less than 5 years old, in a specific year.
• Unit of measure: Cases

D7: Number of cases of diphtheria registered during the year among children <5 years of age


• Number of reported diphtheria cases in children less than 5 years old in a specific year.
• Unit of measure: Cases

D8: Number of cases of whooping cough registered during the year among children <5 years of age


• Number of reported whooping cough cases in children less than 5 years old in a specific year.
• Unit of measure: Cases

D9: Number of cases of neo-natal tetanus registered during the year


• Number of reported neo-natal tetanus cases in a specific year.
• Unit of measure: Cases

D10: Number of yellow fever cases registered during the year


• Number of reported yellow fever cases in a specific year.
• Unit of measure: Cases

D11: Number of cases of plague reported during the year


• Number of reported plague cases in a specific year.
• Unit of measure: Cases

D12: Number of cases of dengue registered during the year


• Number of reported dengue cases in a specific year.
• Unit of measure: Cases

D13: Number of cases of human rabies registered during the year


• Number of reported human rabies cases in a specific year.
• Unit of measure: Cases

D14: Number of cases of congenital syphilis registered during the year


• Number of reported congenital syphilis cases in a specific year.
• Unit of measure: Cases

D15: Number of cases of cholera registered during the year


• Number of reported cholera cases in a specific year.
• Unit of measure: Cases

D16: Annual parasite index for malaria


• Number of microscopically confirmed cases of malaria registered in a year, per each 1,000 individuals under surveillance.
• Unit of measure: Per 1,000 population under surveillance

D17: Number of cases of syphilis registered during the year


• Number of new cases of syphilis registered during one specific year.
• Unit of measure: Cases

D18: Annual number of cases of tuberculosis


• The number of cases with positive AFB registered during a year.
• Unit of measure: Cases

D19: Number of AIDS cases registered during the year


• Number of new AIDS cases reported in a specific year.
• Unit of measure: Cases

D20: Prevalence of leprosy cases


• Total number of leprosy cases present in a specific year.
• Unit of measure: Cases

D21: Proportion of women of childbearing age currently using any type of contraceptive


• A woman of childbearing age is defined as aged 15-49 years. Contraceptive methods include: female and male sterilization, injectable and oral contraceptives, intrauterine devices, diaphragms, spermicides, condoms, rhythm method, withdrawal and abstinence.
• Unit of measure: Percent

D22: Adolescent fertility rate (under 29 years of age)


• Is the ratio, for given year, between the number of live birth (numerator) in a given population and the number of females 15 to 19 years old in the same population (denominator). It is recommended that 1,000 multiply this quotient.
• Unit of measure: By 1,000 women 15-19 years of age

D23: Incidence of malignant neoplasms of the lung


• It is the quotient, for a given year, between the number of new cases of malignant neoplasms of the lung (Code 162 in the ICD-9 and Codes C33-C34 in ICD-10, both include trachea and bronchus) and the total population of the area where cases are occurring. It is recommended that this quotient be multiplied by a power of 105.
• Unit of measure: Per 100,000 population

D24: Incidence of malignant neoplasms of the stomach


• It is the quotient, for a given year, between the number of new cases of malignant neoplasms of the stomach (Code 151 in the ICD-9 and Code C16 in ICD-10) and the total population of the area where cases are occurring. It is recommended that this quotient be multiplied by a power of 105.
• Unit of measure: Per 100,000 population

D25: Incidence of malignant neoplasms of female breast


• It is the quotient, for a given year, between the number of new cases of malignant neoplasms of female breast (Code 174 in the ICD-9 and Code C50 in ICD-10) and the total population of the area where cases are occurring. It is recommended that this quotient be multiplied by a power of 105.
• Unit of measure: Per 100,000 population

D26: Incidence of malignant neoplasms of cervix uteri


• It is the quotient, for a given year, between the number of new cases of malignant neoplasms of cervix uteri (Code 179 in the ICD-9 and Code C53 in ICD-10) and the total population of the area where cases are occurring. It is recommended that this quotient be multiplied by a power of 105.
• Unit of measure: Per 100,000 population

D27: Prevalence of hypertension


• The quotient, for a given year, between the number of individuals with hypertension and the population of the area where the cases are occurring. It includes the cases that existed before the year began and that continue throughout the year or part of it, as well as the new cases that have occurred during the year. This quotient is usually multiplied by a power of 10.
• Unit of measure: Per 100,000 population

D28: Prevalence of diabetes mellitus type 2


• The quotient, for a given year, between the number of individuals with diabetes mellitus type 2 and the population of the area where the cases are occurring. It includes the cases that existed before the year began and that continue throughout the year or part of it, as well as the new cases that have occurred during the year. This quotient is usually multiplied by a power of 10.
• Unit of measure: Per 100,000 population

D29: Prevalence of overweight among adults (20-74 years)


• The quotient, for a given year, between the number of overweight individuals and the population of the area where the cases are occurring. Overweight is measured by means of the Body Mass Index (BMI). The BMI is an anthropometric measure defined as the ratio between the weight, measured in kilograms (numerator), and the square of the height, expressed in meters (denominator). Overweight is considered to exist when the BMI is equal to or greater than 25.
• Unit of measure: Percent

D30: Proportion of youth 15-19 years of age who smoke


• Prevalence of current smokers, that smoke daily (at the moment of the survey) among the population 15 to 19 years old. It is recommended to express the proportion as a percentage.
• Unit of measure: Percent

E1: Population with access to health services


• Given the complexity of its functions, measurement of coverage by the health system is not easy. The degree of coverage and social access can vary considerably between the primary and tertiary levels of care. Even within the primary level there are differences between immunization programs, mental health care, and the treatment of cardiovascular diseases, for example. In the 1994 edition of Health Conditions in the Americas, an access indicator was defined, based on two basic services fundamental to health care: care at the moment of birth and care at the moment of death. Delivery coverage was defined as the percentage of births attended by trained personnel versus the total estimated births. For deaths, coverage was defined as the percentage of deaths registered with a medical certification versus the total estimated deaths. The percentage of the population with access to health services is calculated as the average of these two values.
• Unit of measure: Percent

E2: Percent of urban population with potable water trough house connections


• The population that receives drinking water services through household connections to drinking water systems.
• Unit of measure: Percent

E3: Percent of urban population with reasonable access to public sources of potable water


• The population that has reasonable access to drinking water. In urban areas the criterion for determining "reasonable access" is a distance of 200 meters from housing to a public water source. In rural areas the definition of access is more flexible and depends on the topography and other environmental factors.
• Unit of measure: Percent

E4: Percent of rural population with reasonable access to potable water


• The population that has reasonable access to drinking water. In urban areas the criterion for determining "reasonable access" is a distance of 200 meters from housing to a public water source. In rural areas the definition of access is more flexible and depends on the topography and other environmental factors.
• Unit of measure: Percent

E5: Percent of urban population with house connections to public sewer systems


• In urban areas, this is the population with household connections to public sewerage systems.
• Unit of measure: Percent

E6: Percent of urban population served by individual systems of excreta disposal


• In urban areas, this is the population whose dwellings have septic tanks and latrines. In rural areas this indicator refers to the individual systems (for the most part latrines) but also includes other systems such as the septic tanks and drains.
• Unit of measure: Percent

E7: Percent of rural population having adequate sanitary of excreta disposal


• In rural areas this indicator refers to the individual systems (for the most part latrines) but also includes other systems such as the septic tanks and drains.
• Unit of measure: Percent

E8: Percent of population with access to disinfected water supplies


• Proportion of the population who has access to drinking water that has been disinfected by methods that eliminate biological agents at concentration levels that are hazardous to health.
• Unit of measure: Percent

E9: Percent of urban population with regular collection of solid waste


• This measure refers to urban areas where permanent systems and periodic collection of solid waste is available.
• Unit of measure: Percent

E10: Percent of children under 1 year attended by trained personnel


• It is the percentage of infants who have had at least one consultation during the first year of life with a trained health worker.
• Unit of measure: Percent

E11: Percent of children <1 year vaccinated against diphtheria, whooping cough, and tetanus


• Proportion of children who, on completing their first year of life, has received three doses of DPT toxoid.
• Unit of measure: Percent

E12: Percent of children <1 year vaccinated against measles


• Proportion of children who, on completing their first year of life, has received one dose of measles vaccine.
• Unit of measure: Percent

E13: Percent of children <1 year vaccinated against poliomyelitis (OPV3)


• Proportion of children who, on completing their first year of life, has received three doses of live oral poliomyelitis vaccine.
• Unit of measure: Percent

E14: Percent of children <1 year vaccinated against tuberculosis (BCG)


• Proportion of children who, on completing their first year of life, has received the vaccine against tuberculosis (BCG).
• Unit of measure: Percent

E15: Percent of pregnant women attended by trained personnel during pregnancy


• Pregnant women who have received at least one consultation during their pregnancy and not only services immediately prior to delivery. Does not include direct vaccination activities, already included in another indicator, but does include monitoring of the pregnancy and ambulatory care for associated morbidity. The trained personnel refer to the ability to provide the necessary supervision, care and advice to women during pregnancy, labor and the post-partum period, to conduct deliveries on their own responsibility and to care for the newborn and the infant. Since the number of pregnant women is generally not available, the number of live births is used as a denominator.
• Unit of measure: Percent

E16: Percent of pregnant women attended by trained personnel during 1st trimester of pregnancy


• Pregnant women who have received at least one consultation during the first trimester of pregnancy and not only services immediately prior to delivery. Does not include direct vaccination activities, already included in another indicator, but does include monitoring of the pregnancy and ambulatory care for associated morbidity. The trained personnel refer to the ability to provide the necessary supervision, care and advice to women during pregnancy, labor and the post-partum period, to conduct deliveries on their own responsibility and to care for the newborn and the infant. Since the number of pregnant women is generally not available, the number of live births is used as a denominator.
• Unit of measure: Percent

E17: Percent of deliveries attended by trained personnel


• The number of deliveries attended by trained personnel in a given year versus the total number of births in that same year. The trained personnel refer to the ability to provide the necessary supervision, care and advice to women during pregnancy, labor and the post-partum period, to conduct deliveries on their own responsibility and to care for the newborn and the infant. The site of the delivery is not taken into account.
• Unit of measure: Deliveries

E18: Tetanus toxoid vaccination among women of childbearing age (12 to 49 years) living in high-risk areas


• High-risk areas are defined as geographical units that have registered a higher frequency of neonatal tetanus than the national average in the five years prior to the report. The vaccination coverage is represented by the cumulative percentage of women 12 to 49 years old that has received at least two doses of tetanus toxoid during the last 5 years.
• Unit of measure: Percent

E19: Ambulatory care (any type) per inhabitant per year


• Every professional encounter or contact between a non-hospitalized individual and a health worker responsible for the evaluation, diagnosis, treatment, or referral of that person. Includes encounters in the outpatient units of hospitals, sanatorium, health centers, health posts, patients' residence, physicians' offices, etc. Encounters between physicians and hospitalized patients are excluded. Consultations carried out in the emergency services are usually considered separately.
• Unit of measure: Contacts

E20: Hospitalized patients


• Every person formally admitted to a hospital for observation, care, diagnosis, or treatment.
• A hospital is any medical facility with an organized medical and professional staff and beds available for continuous hospitalization, whose primary function is to provide medical services, treatment, and other health care services to hospitalized patients, for surgical and non-surgical activities. Usually provides outpatient services, especially emergency care. Two types of hospitals are included: short-stay (average stay of 30 days) or less) and extended-stay (average stay of more than 30 days; also provides social and rehabilitation services, spiritual and emotional support, and comprehensive prevention services).
• Discharge is the formal release of a hospitalized patient-- that is, the termination of the period of hospitalization, either by death, return home, or transfer to a geriatric center or different hospital.
• Unit of measure: Per 100 population

E21: Population per physician


• The ratio, for a given year, between the mid-year population and the total number of physicians licensed to practice in the country.
• Unit of measure: Inhabitants per physician

E22: Number of graduates in medicine


• The total number of individuals obtaining a medical doctor degree from a recognized university in a given year.
• Unit of measure: Physicians

E23: Population per university-trained professional nurse


• The ratio, for a specific year, between the mid-year population and the number of university-trained professional nurses (Registered Nurse equivalent).
• Unit of measure: Inhabitants per nurse

E24: Number of university graduates in professional nursing


• The total number of individuals obtaining a nursing degree (Registered Nurse equivalent) from a recognized university in a given year.
• Unit of measure: Nurses

E25: Population per non-university trained nursing personnel


• The ratio, for a specific year, between the mid-year population, and the number of qualified (by formal education or special training) personnel, which are authorized, under national regulations to provide personal care (observation and direct care) to the population, for problems related to health. Depending on the level of education there are several categories: auxiliary, assistant, technician, licensed, etc. with several specializations, many times the training is in-service.
• Unit of measure: Inhabitants per nursing personnel

E26: Population per dentists


• The ratio, for a specific year, between the mid-year population and the number dentists licensed to practice in the country.
• Unit of measure: Inhabitants per dentist

E27: Population per hospital bed


• The ratio, for a specific year, between the mid-year population and the number of hospital beds available in a country; includes acute and extended-care beds.
• Unit of measure: Inhabitants per hospital bed

E28: Number of ambulatory care establishments


• It is any facility whose primary objective is to deliver health care services (observation, diagnosis, or treatment) to non-hospitalized individuals.
• Unit of measure: Facilities

E29: National health expenditure as a percent of GNP


• The sum of all health expenditures of the public (ministry of health, social security) and private sectors (numerator) and GDP (denominator).
• Unit of measure: Percent

E30: Public hospital expenditures as a percentage of government health expenditure


• The total of all expenditures by public authorities of the country or its parts, instrumentalities, agencies, for hospital care service (including health care products). Hospitals include: general, specialized, maternity services, nursing and convalescent home services as numerator and the sum of all health expenditures of the public sector as denominator.
• Unit of measure: Percent

E31: Government health expenditure as percent of national health expenditure


• The total of all health expenditures by public authorities (not limited to the ministry of health) of the country or its parts, instrumentalities or agencies, for health care services and health care products. These include: hospital services, clinics, and medical, dental, and paramedical practitioners, public health affairs and services, medicaments, prostheses, medical equipment and appliances, applied research related to the health and medical delivery system as numerator and the sum of all health expenditures of the public (ministry of health, social security) and private sectors as denominator.
• Unit of measure: Percent

E32: Underregistration of births


• The lack of registry of a vital event, even late, is called underregistration. Underregistration of the births is the ratio of births not registered until one year after the birth, to the total estimated births, expressed as a percentage.
• Unit of measure: Percent

E33: Percent of birth registrations that are for children over 1 year old at time of registration


• It is the ratio between the number of births certificates issued for children who were 1 year of age or older at the time of registration and the total children registered in a given year.
• Unit of measure: Percent

E34: Underregistration of mortality


• The lack of registry of a vital event, even late, is called underregistration. Underregistration of mortality is the ratio of deaths not registered to the total estimated deaths, expressed as a percentage.
• Unit of measure: Percent

E35: Deaths with medical care as a percentage of registered deaths


• The percentage of deaths registered with a death certificate signed by a physician. This is an additional indicator for measuring the quality of death registries.

E36: Deaths due to signs, symptoms and ill-defined conditions as a % of registered deaths


• The percentage of deaths due to signs, symptoms and ill-defined conditions to the total registered deaths. The ICD 9 assigns codes 780-799 to these conditions; the ICD 10, R00-R99.
• Unit of measure: Percent