Vital statistics are data on vital events: live births, deaths, fetal deaths, marriages, and related events. Health statistics is the broader set that includes morbidity (illness), service coverage, and health resources. Together they are the numbers behind every community diagnosis and program evaluation.

Sources of data in the Philippines

• Civil registration — births, deaths, and marriages registered with the local civil registrar and compiled nationally by the Philippine Statistics Authority (PSA)
• Census of population (PSA) — denominators for rates
• Field Health Service Information System (FHSIS) — the DOH's official routine reporting system for public health services, morbidity, and mortality, built from Individual Treatment Records (ITR) and Target Client Lists (TCL) at the BHS and RHU level
• Disease surveillance (PIDSR) — notifiable diseases (Topic 9)
• Surveys — for example, the National Demographic and Health Survey (NDHS)

Three types of measures

Crude, specific, and standardized rates

• Crude rates use the whole population (crude birth rate, crude death rate). They are easy to compute but are affected by the age structure.
• Specific rates restrict both numerator and denominator to a subgroup (age-specific, sex-specific, cause-specific).
• Standardized (age-adjusted) rates remove the effect of different age structures so that two communities can be compared fairly. An older barangay will have a higher crude death rate even if its health is no worse.

Denominator. For annual rates, use the midyear population (population as of July 1). If only start- and end-of-year counts are given: (start + end) ÷ 2.

Core formulas (standard multipliers)

A maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Perinatal definitions vary by source. The WHO uses stillbirths at 28 weeks or more for international comparison, while the ICD perinatal period begins at 22 completed weeks; national statistical offices and textbooks may use other cut-offs. Use the gestational cut-off and denominator stated in the question. The neonatal period is the first 28 days (early neonatal: first 7 days; late neonatal: day 7 to before day 28).

Interpretation keys

• IMR is the most sensitive single indicator of a community's health and socioeconomic status.
• A high Swaroop's index means most people live past 50 — a sign of better health.
• CFR measures the severity (lethality) of a disease, not the risk of catching it.
• Incidence measures risk (new cases); prevalence measures burden (all cases). Prevalence ≈ incidence × average duration. A new treatment that keeps people alive without curing them raises prevalence; a faster cure lowers it.

Worked examples — Municipality A, one calendar year. Midyear population 50,000; live births 1,100; total deaths 300; infant deaths 22 (12 neonatal, 10 post-neonatal); maternal deaths 1; women aged 15–49: 12,500; population 65 and older: 3,000 with 120 deaths; deaths from cardiovascular disease 45; deaths at age 50 and older 180.

1. CBR = 1,100 ÷ 50,000 × 1,000 = 22 per 1,000 population

Check: 1,100 ÷ 50,000 = 0.022; 0.022 × 1,000 = 22 ✓

1. GFR = 1,100 ÷ 12,500 × 1,000 = 88 per 1,000 women 15–49

Check: 1,100 ÷ 12,500 = 0.088; × 1,000 = 88 ✓

1. CDR = 300 ÷ 50,000 × 1,000 = 6 per 1,000 population

Check: 300 ÷ 50,000 = 0.006; × 1,000 = 6 ✓

1. IMR = 22 ÷ 1,100 × 1,000 = 20 per 1,000 live births

Check: 22 ÷ 1,100 = 0.02; × 1,000 = 20 ✓

1. NMR = 12 ÷ 1,100 × 1,000 = 10.9 per 1,000 live births

Check: 12 ÷ 1,100 = 0.010909; × 1,000 = 10.9 ✓

1. Post-neonatal mortality rate = 10 ÷ 1,100 × 1,000 = 9.1 per 1,000 live births (10.9 + 9.1 = 20 = IMR ✓)
2. MMR = 1 ÷ 1,100 × 100,000 = 90.9 per 100,000 live births

Check: 1 ÷ 1,100 = 0.000909; × 100,000 = 90.9 ✓

1. Age-specific death rate (65 and older) = 120 ÷ 3,000 × 1,000 = 40 per 1,000 aged 65 and older

Check: 120 ÷ 3,000 = 0.04; × 1,000 = 40 ✓

1. Cause-specific death rate (cardiovascular) = 45 ÷ 50,000 × 100,000 = 90 per 100,000 population

Check: 45 ÷ 50,000 = 0.0009; × 100,000 = 90 ✓

1. PMR (cardiovascular) = 45 ÷ 300 × 100 = 15% of all deaths

Check: 45 ÷ 300 = 0.15 ✓

1. Swaroop's index = 180 ÷ 300 × 100 = 60%

Check: 180 ÷ 300 = 0.6 ✓

Morbidity examples

1. Incidence: 60 new TB cases were registered during the year; population at risk 50,000. Incidence = 60 ÷ 50,000 × 100,000 = 120 per 100,000.

Check: 60 ÷ 50,000 = 0.0012; × 100,000 = 120 ✓

1. Point prevalence: a screening day on 1 June finds 1,500 adults with hypertension (1,200 already known + 300 newly found) among 15,000 adults. Prevalence = 1,500 ÷ 15,000 × 100 = 10%.

Check: 1,500 ÷ 15,000 = 0.1 ✓ — both old and new cases count in prevalence; only the 300 new cases could enter an incidence numerator.

1. CFR: a dengue outbreak has 200 cases and 3 deaths. CFR = 3 ÷ 200 × 100 = 1.5%.

Check: 3 ÷ 200 = 0.015 ✓

1. Midyear population estimate: population 48,000 on 1 January and 52,000 on 31 December → (48,000 + 52,000) ÷ 2 = 50,000 ✓
2. Dependency ratio: ages 0–14 = 15,000; 65 and older = 3,000; 15–64 = 32,000. Ratio = 18,000 ÷ 32,000 × 100 = 56.3 dependents per 100 working-age persons.

Check: 18,000 ÷ 32,000 = 0.5625 → 56.3 ✓

1. Perinatal mortality rate: 1,100 live births; 15 fetal deaths at 28 weeks or more; 8 early neonatal deaths (within 7 days). Rate = (15 + 8) ÷ (1,100 + 15) × 1,000 = 23 ÷ 1,115 × 1,000 = 20.6 per 1,000 total births.

Check: 23 ÷ 1,115 = 0.020628; × 1,000 = 20.6 ✓ (the 8 early neonatal deaths are part of the 12 neonatal deaths ✓)

Presenting data. Use tables and graphs that match the data: bar graphs for categories (causes of death), line graphs for trends over time (monthly cases), pie charts for parts of a whole, population pyramids for age–sex structure. An expansive (broad-based) pyramid shows high fertility and a young population; a constrictive pyramid (narrow base, wider top) shows low fertility and population aging.

• Records every service accurately in the ITR and updates the TCL; data quality at the BHS determines the quality of the national FHSIS report
• Compiles and submits reports on schedule through the RHU
• Encourages timely birth and death registration with the local civil registrar, since unregistered events disappear from statistics
• Computes local rates to identify priority problems and compares them with provincial and national figures
• Uses the correct numerator, denominator, and multiplier; checks totals (e.g., neonatal + post-neonatal = infant deaths)

• Accuracy is an ethical duty. Inflating coverage or omitting deaths to meet targets misdirects resources; falsifying records can also be a prohibited act under RA 11332 when surveillance data are involved.
• Confidentiality: ITRs and TCLs contain sensitive personal information protected by the Data Privacy Act of 2012 (RA 10173). Store them securely; share aggregated numbers, not names.
• Accountability: the nurse signs and is accountable for the records prepared.

Case 1 — Which indicator? The municipal health officer asks which single figure best reflects the overall health status of the town.

• Correct answer: the infant mortality rate.
• Why: IMR responds to maternal health, nutrition, sanitation, immunization, and access to care.

Case 2 — Crude versus standardized. Barangay X (many retirees) has a CDR of 9 per 1,000; Barangay Y (young families) has 5 per 1,000. A councilor concludes that Barangay X has poorer health services.

• Correct action: compare age-standardized or age-specific rates before concluding.
• Why: crude death rates are driven by age structure.

Case 3 — Rising prevalence. After a diabetes program improves treatment, prevalence of diabetes rises although incidence is unchanged.

• Interpretation: people with diabetes are living longer (longer duration). This is not program failure.

• Using total population instead of live births as the IMR or MMR denominator.
• Using × 1,000 for MMR — the standard is × 100,000 live births. Always use the multiplier the question specifies.
• Calling deaths under 1 year "neonatal" — neonatal means the first 28 days; perinatal combines late fetal and early neonatal (first 7 days) deaths over total births.
• Counting only new cases for prevalence, or old cases for incidence.
• Reading a high Swaroop's index as bad — it indicates better health.
• Treating CFR as a measure of how common a disease is.
• Rounding too early; carry decimals and round the final answer.

• CBR and CDR: per 1,000 midyear population.
• IMR, NMR, post-neonatal: per 1,000 live births; IMR = best single health status indicator.
• MMR: maternal deaths per 100,000 live births; maternal death = during pregnancy or within 42 days after.
• Cause-specific death rate: per 100,000 population; age-specific: deaths and population of the same age group.
• CFR = deaths ÷ cases × 100 — severity of disease.
• Incidence = new cases ÷ population at risk; prevalence = all cases ÷ population; P ≈ I × D.
• Midyear population = (start + end) ÷ 2 when not given.
• Crude rates are distorted by age structure → standardize before comparing.
• FHSIS: DOH's official routine system; ITR and TCL at BHS/RHU level. PSA compiles civil registration and census data.
• Swaroop's index high = good; dependency ratio = (0–14 + 65 and older) ÷ 15–64 × 100.