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National Vitamin A Prophylaxis Programme

• The National Prophylaxis Programme against Nutritional Blindness due to vitamin A deficiency (NPPNB due to VAD) was started in 1970
– with the specific aim of preventing nutritional blindness due to keratomalacia
– As an urgent measure to combat the unacceptably high magnitude of xerophthalmic blindness in the country seen in the 1950s and 1960s
• The Programme was started as a 100 per cent centrally sponsored programme

Physical quality of life index (PQLI)

A. Consolidates three indicators:
1. Infant mortality rate
2. Literacy rate
3. Life expectancy at one year of age

B. For EACH component, the performance of the country is placed on a scale from 0 to 100
• 0 = ‘worst performance’
• 100 = ‘Best performance’
The average (arithmetic mean) of the three scores is calculated, which is the PQLI for the country
It also obviously ranges from 0 to 100
Hence, an EQUAL weightage is given to each component

Differences between QUALY and DALY

E.g. when a health intervention is aimed at preventing or treating a non- fatal disease, the relationship between QUALYs gained and DALYs saved depend on age of onset, duration of disease as well as the quality of life and disability weights
Franco Sassi. Calculating QALYs, comparing QALY and DALY calculations, Health Policy Plan (2006) 21 (5): 402-408

QUALY (Quality – adjusted life years)

• A measure of disease burden including both:
– Quality and
– Quantity of life lived
• Used mainly for assessing the value for money of a medical intervention i.e. cost – effective analysis for comparing different interventions
• Based on the number of QUALYs gained by the intervention
• Each year in perfect health = 1.0
• Death = 0.0
• 1 QUALY = one year of life X one utility value = one year of life lived in perfect health
• Half a year lived in perfect health is equivalent to 0.5 QUALY = 1 year X 0.5 utility value

HALE (Health – Adjusted Life Expectancy)

• Previously k/a DALE (Disability Adjusted Life Expectancy)
• Definition: equivalent number of years in “full health” that a new-born can expect to live based on current rates of ill health and mortality
• Indicator used to measure healthy life expectancy
• Based on:
o life expectancy at birth BUT
o Includes an adjustment for time spent in poor health as perceived by the individuals in the following areas of their personal health:
1. Sensory ( vision, hearing and speech),
2. Mobility,

4 Disability Indicators

Life expectancy (LE) estimates are insensitive to the health status of the population.
They provide no indication of the quality of life, only the quantity
Moving beyond LE are the indicators below:

1 HALE (Health – Adjusted Life Expectancy)
2 “Sullivan’s index” or Disability – free life expectancy or Active life expectancy
3 QALY (Quality – adjusted life years)
4 Disability – adjusted life years (DALY)


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