TRAINING COURSE ON VITAL AND HEALTH STATISTICS FOR TERRITORIES IN THE SOUTH PACIFIC AREA
• Sponsored by the WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC
SUVA, FIJI 8 January - 2 February 1962
FINAL REPffiT
•
World Health Organization Western Pacific Regional Office Manila, Philippines March, 1962
WPR/19 2/ 62
TABLE OF CONTENTS
I. •
ImRODUCTION ••.•••••••••••••••••••••••••••••••••• ,. ••••••••••••
1 1 2 2 2
1. 2.
3. II.
Origin of the training course Objectives Date and place
..........................• .•..........••.••..•••.......................• .•.......•..••....•........•..........•.•• .............................• ........................................ .•.••....••.................••.•..•• ••••••••••••••••••••
ORGANIZATION .................................................. .
1.
Teaching staff •••••..•••••••••••••••••.•••.•••••••••••••
2
2.
3. 4.
5. 6. 7. 8. III.
Participants and observers Working language Books and docUlIlents . Equipment • • • • A • • • • • • • • • • • • • • • • • • • • • • Accommodation .~
3 6 6 6 6 6 7 7
Library,."' ••• "................. • •••••••••••••••••••••••••••••
....
"
.......•.••••..•••....•......•••.•...
Workillg hours ............................ "" ••. """ •. "......... ,,.
ACTIVITIES OF THE TRAINING COURSE •••••••••••••••••••••••••••• 1. 2.
Opening session ••••••••••••.•••••••••••••••••••••••••••• Pr:Jgranune :Jf work ••••• "........ "...... "......... " .... ~ .... " .. ,," " • Field visits """ """ "" " """ "" " " " Closing session "" ........ "... ".. "."""." ... """"" .. ,, ..... ,,",,.,,""
3. 4.
..
............. ....
. . .... . ..... .
7 8 9 9 10 10 12
IV.
EV' ALUJ'i.T ION "......... ".. "." ................. ".. """ •• "" ••••• "........ .
1. 2.
Appraisal of results •.••••••••.•..••••...••••••••••••••• Recommendati::>ns """.""." .... """""" .. """ .. " .... " •• ",,.,,""",, ... ,,"
V• •
ACKNCXrIT..EDGE11El'.JTS ""."""." .......... "" .......... """""" .. """"",,.,, ••• ,,.
13
ANNEX I ANNEX II ANNEX III
LIST OF PARTICIPANTS AND OBSERVERS •••••••••••••• LIST OF BOOKS AND DOCUMENTS DISTRIBUTED ••••••••• LIST OF BOOKS I1ND DOCUMENTS IN REFERENCE SYLLABUS OF THE COURSE •••••••••••••••••••••••••• TIMETABLE OF THE COURSE ••••••••••••••••••••••••• CONTENTS OF LECTURES ........... "" .... "."."""" ........ "" .. ,, INDIVIDUAL EVALUATION QUESTIONNAIRE NO.1 " "
15 19 22
...
ANNEX IV ANNEX V ANNEX VI ANNEX VII ANNEX VIII
LIBRARY ." •• "........... ".... "••• "." ..... "...... "." .. """"."".,,
25 27
INDIVIDUAL EVALUATION QUESTIONNAIRE NO.2 " .. "
. ......
31 40 42
......
i
I. 1•
INTRODUCTION
Origin of the training course
•
,
The vital and health statistical services in many island territories in the South Pacific area are not as yet sufficiently well-developed to provide the necessary statistical basis for planning realistic long-term public health programmes for the territory concerned. The naed to strengthen such services has, for some time, been a matter of concern to the World Health Organization Regional Office for the Western Pacific. It was therefore decided to hGld a tnining course on vital and health statistics for territories in the South Pacific Area in January 1962. It was realized that the area to be included covered many island territories where vital and health statistics services were at basic level only, and in some cases almost non-existent. At the same time, some of the areas had fairly well-developed systems of vital and health registration machinery and a statistical organization at least in the developmental stage. Australia and New Zealand, in particular, have long been recognized as among the most highly developed countries of the world in respect of vital and health statistics. For this reason, it was decided to invite statistical experts from these two countries to be largely responsible for the training course. The vital statistics systems of Australia and New Zealand have proceeded along similar lines for a great number of years. In New Zealand, however, the recent development of health statistics by the Medical Statistics Branch of the Department of Health is probably unique in the world and has reached a very high international level. Consequently, the section of the training course dealing with vital statistics was placed in the hands of a WHO consultant from Australia, while that concerned with health statistics was entrusted to another WHO consultant from New Zealand. Co-incident with the lack of development of basic vital and health registration and statistical systems in territories of the South Pacific, there was also a dearth of personnel trained to any recognizable degree in general statistical methodology, although in a few of the territories concerned there were exceptions of a higher standard. In an endeavour to equip all participants attending the course with the training necessary to carry out vital and health statistical programmes in accordance with the training received, the WHO Regional Office for the Western Pacific was made responsible for intensive training in both basic and more advanced statistical methods. Preliminary arrangements were made by Dr. S.K. Quo, WHO Regional Statistician and Programme Evaluator, during his visits to Australia and New Zealand in 1959. Later, in 1961, Dr. Quo again visited these two countries for the purpose of arranging for consultants to take part in the training course in Fiji. As a result of these latter visits Mr. C.E. Gardiner, Medical Statistician of the Department of Health, New Zealand, was selected
•
- 2 -
to be responsible for the health statistics section of the course, and Mr. R.C. Gilligan, Senior Economist (Demography) of the Commonwealth of Australia was appointed to take charge of the vital statistics section. By way of preparation, each consultant was afforded the opportunity of making a field visit. Mr. Gardiner paid a visit to Australia in November 1961, during the course of which he visited Sydney, Melbourne and Canberra. Discussions were held with the Commonwealth and State Officials responsible for vital and health statistics, and inspections made of the various branches of the Government Departments connected with these functions. Mr. Gilligan made a detailed inspection of, and report on, the relevant material available in Netherlands New Guinea and in the Territory of Papua and New Guinea. Unfortunately, after his return from these visits, Mr. Gilligan1s health prevented him from continuing in his appointment as consultant for the training course in Fiji. Consequently, Mr. E.H. Harry of the Australian Commonwealth Bureau of Census and Statistics was nppointed in his place. 2. Objectives The objectives of the training course were: (a) (b) to train basic statistical personnel to meet the actual needs of South Pacific territories; to provide practical training in the methods and procedures for the collection, compilation and analysis of vital and health statistics; to discuss the needs and uses of vital and health statistics in public health administration and equip the trainees with the ability to recognize and compile statistical data of public health importance; to stimulate the development and improvement of vital and health statistical services in territories in the South Pacific area.
,
•
(c)
•
(d)
3.
Date and place
The training course was held for four weeks during the period 8 January to 2 February 1962 at the Fiji School of MediCine, Suva, which is approximately five miles away from the City. II. 1.
..
ORGANIZATION
Teaching staff
The teaching staff consisted of two WHO consultants and one staff member from WHO Regional Office for the Western Pacific as listed below.
- 3 -
Mr. C.E. Gardiner
Medical Statistician in charge of the Medical Statistics Branch, Department of Health, Wellington, New Zealand; member of the WHO Expert Advisory Panel on Health Statistics. Assistant Editor, Commonwealth Bureau of Census and Statistics, Canberra, Australia; formerly Supervisor of the Demography Branch of the Bureau, and Lecturer in Statistics at the Canberra University College • Regional Statistician and Programme Evaluator, WHO Regional Office for the Western Pacific.
Mr. E.H. Harry
., Dr. S.K. Quo
Mr. Harry was responsible for Part I of the syllabus of the training course - Vital Statistics; Mr. Gardiner for Part II - Health Statistics; and Dr. Quo for Part III - Statistical Methods. In addition to the above regular teaching staff, Mr. B.L. Gregg, Registrar-General for Fiji, delivered a special lecture on the system of vital registration and vital statistics in op~ration in the Colony, and Mr. G.E. Martin, Chief Health Inspector of the Medical Department, who is responsible for the health statistics of Fiji, gave a special lecture on the collection, compilation and analysis of health statistical data for the Colony. Dr. S.K. Quo served as Director of the Course and was also responsible for the administrative aspects. He was assisted in this task by Mr. R.S. Pathak, Executive Officer of the Fiji School of Medicine. 2. 2.1
Participants and observers Status
The number of trainees taking part in the course was twenty-two, of whom twenty were participants and two were observers from Fiji. All the participants (other than the two observers) attended the course on fellowships granted by WHO on the recommendation of the government of the eleven territories represented. There were three local participants fram Fiji. The list of participants and observers is given in Annex I, and Table 1 shows the country of origin of all attending the course.
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TABLE 1 Country of origin Part iCipants American Samoa British Solomon Islands Protectorate Cook Islands Fiji Gilbert and Ellice Islands Colony Netherlands New Guinea Territory of Papua and New Guinea Tokelau Islands Tonga United States Trust Territory of the Pacific Islands Ponape Islands Mariana Islands Caroline Islands Western Samoa Total: 2.2 1 1 1
(lJservers
•
3 1
2
2
3 1 1
1 1 2
2 20
2
Sex and age
There was only one female participant, who came from the Territory of Papua and New Guinea. The age distribution is given in Table 2. TABLE 2 Age Distribution Under 25 25 - 34 .................................. . • • • • • • • • III • • • • • • • • • • • • • • • • ,. • • • • •
• 2
35 -
44 ................................. .
45 and over
................••.......... Total:
7 12 1
22
2.3
Education
..
The educational qualifications of the participants varied great~, and to some extent this affected the presentation of lecture material and practical exercises, and certainly contributed to the ability of the trainees to absorb the programme. Eight were graduates in various subjects and five were undergraduates; four had no other educational background than secondary school attendance. Particulars of the educational standard of participants are summarized in Table 3.
- 5 TABLE 3 Education
•
Graduates
Fiji School of Medicine Arts, Commerce, Law Accountancy Fiji School of Medicine Commerce Royal Society of Health other
4
3 1
Undergraduates Health Certificates
4 1 1
2 2 4
other Certificates or Diplomas Secondary School Total: 2.4 Occupation
22
• •
The trainees came from a variety of occupations in their home territories. This again affected the standard of work done during the course and the knowledge gained from the lectures. Some were already doing vital and health statistical work to a limited degree in their own area. Some were occupied as health inspectors and assistant medical officers (AMOs), which was of some considerable value to them in their approach to the health statistics section of the course. Others, however, had no previous experience to equip them far the subject concerned. In the case of these latter trainees, the object of the course was to give them a knowledge of fundamentals to enable them to inaugurate some vital and health statistical programmes in their respective territories in the future. Table 4 gives particulars of the type of government agency by which participants and observers are employed. TABLE 4 Agency Affiliation Fiji PartiCipants Health Services Statistical Services Administration Other 12
3 2
3 2
- 6 2.5 Previous experience
• The previous statistical experience of the participants is summarized in Table 5. TABLE 5 Previous Statistical Experience Yes •
.........................................
9
No ••••••••••••••••••••••••••••••••••••••••••
13
3.
Working language The English language was used exclusively throughout the course.
4.
Books and documents
All participants and observers received, free of charge, books, documents, reference materials, tables of logarithms, slide rules and stationery used at the training course. A list of books and documents distributed to them will be found in Annex II.
5.
Equipment
During the period of the training course four Monroe hand calculating machines were provided for exercise in mechanical calculation of statistical data. Ample accommodation was made available in the Fiji School of Medicine for lectures, demonstrations, discussion groups and statistical exercises. The trainees used expandable office supplies from the stock belonging to the School, WHO being debited with the cost of supplies actually used. Two typewriters were also lent by the School.
•
6.
Library
The facilities of the reference library of the Fiji School of Medicine were extended to the trainees, and a special reference library was established for their use, comprising reference books, documents and reports relevant to the course, a list of which is contained in Annex III. One of the participants, who was a staff member of the School, was put in charge of this library .• 7. Accommodation
..
Participants from outside Fiji and those from Fiji but residing outside Suva were lodged and had their meals in the Fiji School of Medicine. The one female participant was accommodated in the Central Nursing School located in the immediate vicinity of the School of Medicine.
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B.
Working hours
•
The working hours were from 09.00 to 12.30 hours, and from 13.30 to 16.00 hours, Monday through Friday. During the four-week period of the course, there were twenty w:rking days, each of two sessions, providing a total of ten three and a half and ten two and a half hour working sessions. In general, Saturdays and Sundays were free. In actual practice, the trainees worked many evenings on the various tests set, sometimes to a late hour of the night. This was a reflection of the keen interest taken by the participants in the practical work of the course, as the lecturers were prepared, if necessary, to allow extra time during the lecture periods far practical work on the exercises provided. III. 1.
ACTIVITIES OF THE TRAINING COURSE
sPening session
The training course was formally opened at 12.00 hours on Monday, 8 January under the chairmanship of Dr. S.K. QU8. Also present were Dr. A.R. Edmonds, Principal of the Fiji School of Medicine, and Dr. D.W. Bookles representing Dr. P.W. Dill-Russell, Director of Medical Services in Fiji.
•
Dr. Edmonds, in opening the course, said that all who had anything to do with medicine and health realized that they were working in the dark unless they knew something of the facts of the countries with which they were dealing, particularly with regard to vital and health statistics. They also realized that in countries where much progress had still to come and where a number of the people were living in relatively simple and primitive conditions, the difficulties of acquiring accurate information were very much greater than in the more developed countries, and their need for accurate information was even greater. The people working in those territories had limited means, physically and finanCially, to apply what they thought were the necessary correctives and training and application of health principles, and unless they had reasonably accurate inf~mation on which to base their efforts these were likely to be wasted. Dr. Quo concluded the opening ceremony by reading a message of welcome and good wishes from Dr. I.C. Fang, Regional Director, WHO Regional Office for the Western Pacific. In his message Dr. Fang said that it was well recognized that the effective planning of public health programmes was, to a large extent, dependent on the availability of adequate vital and health statistics which made it possible to evaluate health problems accurately and, therefore, to adopt effective public health measures. In areas where health needs were great, h~ever, adequate statistics were not always readily obtainable. The vital and health statistical services in many island territories in the South Pacific area were not as yet sufficiently well-developed to provide the necessary statistical basis for planning realistic long-term public health programmes for the territar.r concerned. It was felt that the
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training of personnel was most essential for improvement of statistical services, and it was realized that the most efficient way of training statistical personnel for many territories at the same time was by conducting seminars or training courses. He was happy and grateful that the Government of Fiji had agreed to have the training course held at the Fiji School of Medicine and to provide the aS3istance required for the succesful operation of the project. 2. Programme of work Introduction
•
•
2.1
•
In his introductory lecture Dr. Quo gave a resume of previous similar seminars already held under the auspices of WHO and outlined to the partiCipants the material that would be made available and the method of instruction that would be followed. In general this was to be by the distribution of lecture notes and other relevant literature for stuqy before each lecture. The course would then follow a programme of lectures and practical tests set by the teaching staff. On Thursday, 11 January the participants elected two persons to serve as their representatives on matters calling for liaison with the teaching staff.
2.2
Conduct of the course
The course was conducted in such a way as to provide practical training in the methods and procedures for the collection, compilation and analysis of vital and health statistics which would be used by public health administrators in health planning and programme evaluation. A detailed timetable of lectures is given in Annex V. Lectures on the subjects were followed by demonstrations, discussions and laboratory exercises, and more time was allotted to exercises than to lectures. Exercises and questions on each subject were prepared for the trainees to work out and the reports turned in by them were corrected by the teaching staff. An outline of each lecture was prepared and distributed to the trainees prior to the lecture so as to facilitate their understanding, and the trainees were free to ask questions during lecture hours.
•
•
2.3
Content of the course
.
As this was an elementary course aimed at training basic statistical personnel, the content of the subjects covered was essentially practical, realistic and properly geared to the working conditions of the trainees in their respective Territories. The subjects covered in the training course are given in Annex IV and Annex VI gives a brief outline of the material contained in the lectures.
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3.
Field visits
• •
Fiehd visits were made by the participants to study the organization and operation of the vital and health statistical services of the Fiji Government. Special lectures were given by government officers responsible for vital registration, vital statistics and health statistics in Fiji. On Thursd~, 11 January the participants were conveyed by bus to the Registrar-General's Department in the Government Buildings, Suva. Mr. M.T. Khan, on behalf of the Registrar-General, conducted the participants through the vari::JUs stages of registration of vital events in Fiji such as births, deaths and marriages, and gave an explanatory talk on the method of registration, copying and issuing of documents in connection with these events. An outline was also given of the statistical treatment of the vital events and the method of indexing the registers. As mentioned previous~, a one-hour lecture on the subject of vital registration and vital statistics in Fiji was also given during the course by the RegistrarGeneral, Mr. B.L. Gregg. A further field visit was made on Tuesday, 16 January to the Medical Department of Fiji. There the participants were shown in detail the workings of the Medical Department, particularly in relation to the recording of notifiable diseases, the BCG vaccination programme and the work of the health inspectors. This visit was superintended by Mr. G.E. Martin, Chief Health Inspector of the Medical Department, who also delivered a one-hour lecture during the course on the collection and compilation of health statistics in Fiji. Transport for these field visits was provided by the Fiji Government.
•
4•
CloSing session
The concluding ceremony was held in the Lecture Hall of the Fiji Sch:)ol of Medicine. All participants am observers were present, together with the teaching staff of the course. Special guests included Dr. W.H. McDonald, Acting Director of Medical Services, Fiji, D~ A.R. Edmonds, Principal of the Fiji School of MediCine, and Mr, G.E. Martin, Chief Health Inspector of the Medical Department, Fiji. Dr. Quo brief~ outlined the achievements of the training course, and Dr. McDonald made suitable reference to the value of the training received to the participating territories and to Fiji in particular. He also expressed his thanks to WHO for arranging the course, and to the teaching staff for the valuable work done.
Mr. P. Robati, representing the trainees, replied suitab~, and in particular emphasized the great stimulus which had been provided, to their interest in vital and health statistics. He expressed the belief that in all the territories represented there would be earnest attempts made to encourage
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the governments concerned in developing their vital and health statistical services. Special thanks were accorded the teaching staff for their friendly approach and willingness to assist in all problems arising out of the subjects covered in the course. IV. 1. Appraisal of results EVALUATION
•
•
•
An appraisal of the results obtained is best considered under the various headings set out in the objectives of the course. 1.1 Training of basic statistical personnel to meet the actual needs of South Pacific territories
During the course an opportunity was afforded all trainees to describe the systems of vital and health statistics actually in ex.istence in their respective territories. It was immediately seen that considerab1B difficulty would be experienced in moulding the framework of the lectures and practical exercises to fit a vastly ranging pattern ~f existing needs. The level of the practical work done, however, showed that this objective had been achieved to an extent beyond expectation. In addition, each of the lecturers discussed individual problems of administ~ation with the trainees and suggested remedies wherever possible. 1.2 The proviSion of practical training in the methods and procedures for the collection, compilation and analysis of vital and health statistics
This created no specific difficulties, except that because of the varying standards ot experience and educational qualifications, some re-arrangement of the exercises became necessary. The work done by the trainees, as mentioned earlier, was quite remarkable and provided evidence that the practical training aspects of the course fully served the purpose for which they were designed.
•
1.3
To familiarize the trainees with the needs and uses of vital and health statistics in public health administration and equip them with the ability to recognize and compile statistical data of public health importance
•
This objective was covered mainly in the lecture material. However, questions set to evaluate the degree of absorption of the trainees again revealed a high degree of assimilation. It should be possible, therefore, for the majority of trainees to assess the statistical needs of their territories and to compile statistical data fQrthe use of public health administrators.
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1.4
Improvement and development of vital and health statistics
• •
It has emerged from the course that still more encouragement of the trainees, and advice to the authorities in the home territories, will be required by way of follow-up training and organization •
1.5
Immediate results
'I
As regards immediate results, it can be said that the complete programme was carried through as planned, and the general aims and objectives aChieved. The opportunity provided for the trainees to obtain detailed information and illustrations of the vital and health statistical procedures in Australia and New Zealand must be of considerable future benefit.
1.6
Administrative aspects
Two evaluation questionnaires were prepared for the use of the trainees in assessing, on an individual basis, the administrative aspects and the achievements of the course. Participants were asked to check the appropriate prepared statements and they were also invited to express their frank critiCisms, suggestions and comments (unsigned). A summary of the results of the individual assessments is presented in Annex VII and Annex VIII. l.? Summary
It was not practical to include in this report the comments and criticisms made by the trainees, but the following brief summary epitomises the general response to the questionnaires: • 1•
.. 2.
There was a general feeling that the time was too short. Of particular interest was the expression of opinion that the length of the course should have been extended up to six weeks, and no suggestions were made that the actual syllabus should have been cut down to fit more neatly into the four weeks allowed. More time was requested for practical work. Preference was expressed in some cases that the three sections of the course, Vital Statistics, Health Statistics and Statistical Methodology, should have been concentrated into separate extended periods, instead of being widely dispersed throughout the syllabus. A keen interest was displqyed in the possibility of holding any future courses of this nature in one of the more developed countries such as New Zealand or Australia. The particular point was made that this would enable the participants to see a large statistical office under normal working condition, instead of receiving only a theoretical explanation.
3.
4.
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5. 2.
Many trainees showed a desire to attend a more advanced course at a later date.
. •
Recommendations
2.1 It is firmly recommended that an advanced course, covering a similar syllabus, should be held in either Australia or New Zealand in three or four years' time, preferably for as many as possible of the participants who attended this present elementary course. This proposal was in fact commented upon by Dr. Quo in his Report on a Field Visit to New Zealand during May 1961, as follows: "In his discussion wi th the Regional Statistician, Dr. H.B. Turbett, Director-General of Health, New Zealand, commented that inasmuch as this training course is an elementary one aimed at bringing up basic statistical personnel badly needed by the administrations of the South Pacific territories, it would be necessary that three or four years later an advanced course should be organized by WHO to provide additional training for those who have attended the elementary course. It is believed that this is a very useful suggestion made by Dr. Turbott who, cognizant of the importance of health statistics in health planning and programme evaluation, created thirteen years ago the Medical Statistics Branch in the Department of Health. It is felt that, subject to the agreement of the New Zealand Government, an advanced training course could be profitably conducted in Wellington, as the facilities and staff of the Medical Statistics Branch would be made available for the course." 2.2 Arising out of the comments of the trainees, the following alternatives are suggested for possible improvements in the training programme for any future course: 2.2.1 Each main section of the syllabus, e.g. vital statistics, health statistics and statistical methodology, should be concentrated more continously, thus giving the participants greater continuity in each subject. This would impose a much greater strain on the lecturers, although each would have a larger time free from lecturing, to be devoted to the correction of exercises and relaxation. The participants should be divided into smaller groups, and each group taken separately by each lecturer, covering the particular special field for which he was appointed.
•
•
2.2.2
Of the two alternatives mentioned in the above recommendations, the present consultants prefer the second arrangement.
- 13 2.3 Every encouragement should be given to selected participants to obtain WHO fellowships for further concentrated studies in one of the more developed countries, such as Australia or New Zealand. AlsO, in certain areas it would be of considerable advantage for a WHO consultant to spend up to six months in assisting in the development of the statistical machinery in those areas. Unquestionab~, if the training received by the participants is to reap the maximum benefit, some such assistance would be invaluable in enabling them to utilize to the fullest extent the knowledge and experience gained at this course. It was impressed upon the participants to whom these recommendations particular~ app~, that an approach should first be made by them to their respective local authorities to seek the assistance of WHO in this respect. The consultants of the course were prepared, where necessary or desirable, to add their recommendations to this effect • V. ACKNOWLEDGEl1ENTS
•
•
Much of the smooth running of a course such as this depends on the willing co-operation of various people not directly concerned with its operation. In the present instance acknowledgement should be made of the help given, often at considerable personal inconvenience, of the following: The Government of Fiji and the Director of Medical Services, for making available the facilities of the Fiji School of Medicine for the holding of the course. Dr. A.R. Edmonds, Principal of the Fiji School of Medicine, and his deputy, Mr~ K.J~ Gilchrist, for the extreme pains taken to make the detailed arrangements for the site of the course, and for the accommodation of the participants.
.. •
Mr. G.E. Martin, Chief Health Inspector, Fiji Medical Department, who, with Dr. Edmonds, took much trouble in clearing many of the documents sent from outside Fiji for use in the course • Dr. Edmonds, Mr. Martin, the Fiji Registrar-General, Mr. B.L Gregg, and the Acting Director of Medical Services, Dr. McDonald, who spoke at various sessions of the course • The Governments of Australia and New Zealand for making available the services of Mr. E.H. Harry and Mr. C.E. Gardiner respectivelY as WHO conSUltants for the training course.
Mr. R.S. Pathak, Executive Officer at the Fiji School of Medicine for acting as Finance Officer assisting Dr. Quo.
- 14 -
Messrs. Lamson Paragon Limited, New Zealand, for supplying Paramount Punch Card equipment for demonstration purposes. The Registrar-General, Sydney, New South Wales, and the Deputy Commonwealth Statistician, New South Wales, for supplying specimen forms and instruction manuals. The Medical Statistician, Medical Statistics Branch, New Zealand, for the supply of books, documents, instruction manuals, etc. concerning medical statistics in New Zealand. The two secretaries, Mrs. B.P. Smith and Miss M.P. Sharan, and the many other employees of the various Departments involved for the willing and able wqy in which they carried out their duties.
•
•
•
- 15 ANNEX I
LIST OF PARTICIPANTS AND OBSERVERS
•
PARTICIPANTS American Samoa Mr. Puleisili Tuia'ana
Accounting Clerk Department of Medical Services Pago-pago American Samoa
•
British Solomon Islands Protectorate
Mr. Patrick Charles Taylor Executive Officer Medical Department Honiara British Solomon Islands Protectorate Mr. Pupuke Robati
Cook Islands
Assistant Medical Officer Health Department Rarotonga Cook Islands Fiji Mr. Purshottam Krishnan Health Inspector Health Office Suva Fiji
Mr. Epeli T. Rokocoko Assistant Health Inspector Fiji School of Medicine Suva Fiji Mr. Peni Vuiyale
•
Assistant Medical Officer Medical Department Suva Fiji Gilbert and Ellice Islands Colony Mr. Teinamat i Mereki
Assistant Medical Officer Medical Department Tarawa Gilbert and Ellice Islands Colony
- 16 -
ANNEX I • Netherlands New Guinea Mr. Hendrikus Engelbertus Bakker
Medical Assistant Department of Public Health Hollandia-Dok II Netherlands New Guinea
•
Mr. Bart Anne Buschkens Registration Officer Registration Office Bureau of Native Affairs of the Department of Internal Affairs Hollandia-Dok II Netherlands New Guinea Territor,y of Papua and New Guinea Miss Dorothy Joan Williams Senior Compiler Bureau of Statistics Konedobu Papua
Mr. Linley Ralph Foster Assistant District Officer Grade 2 Department of Native Affairs Konedobu Papua Mr. Alan D'Arcy Dudley Senior Radiographer Grade 2 (Special duties in Statistics Section) Department of Public Health Konedobu Papua Tokelau Islands
Mr, Opeta Faraimo Clerk Department of Administration Tokelau Islands Administration Apia Western Samoa Mr. Samuela Ha'unga Assistant Sanitary Inspector Medical Department Nuku'alofa Tonga
•
Tonga
- 17 ANNEX I
•
United States Trust Territory of the Pacific Islands
Mr. Carlos Sablan Camacho Medical Department Chalan Kanoa Saipan, Mariana Islands U.S. Trust Territory of the Pacific Islands C/- Fiji School of Medicine Suva Fiji
Mr. Hirosi Harold lamasl Department of Health Ponape Islands U.S. Trust Territory of the Pacific Islands C/- Fiji School of Medicine Suva Fiji Mr. Anthony Henaro Polloi Medical Department Korar, Palau, Western Caroline Islands U.S. Trust Territory of the Pacific Islands
•
C/- Fiji School of Medicine Suva Fiji
Mr. Nobuo W. Swei Medical Department Koror, Palau, Western Caroline Islands U.S. Trust Territory of the Pacific Islands
• Western Samoa
C/- Fiji School of Medicine Suva Fiji
Mr. Rudolf Patrick Keil Census Clerk Census Section Prime Minister's Department Apia Western Samoa
- 18 -
ANNEX I II
Western Samoa (cont'd.)
Mr. Leota F.I. Tautasi Public Health Officer Division of Public Health Health Department Apia Western Samoa OBSERVERS t
Fiji
Mr. Mohammed Tahir Khan Higher Executive Officer Registrar-GeneralIs Department Suva Fiji Mr. Ratilal Narainji Lodhia Executive Officer Commerce & Industries Office Government Buildings Suva Fiji
•
•
- 19 ANNEX II
LIST OF BOOKS AND DOCUMENTS DISTRIBUTED
•
(1) (2) (3)
Australia, Commonwealth Bureau of Census and Statistics (1958) Australian life tables, 1953-1955, Canberra Australia, Commonwealth Bureau of Census and Statistics (1961) Abridged life table for Australia, 1959~1960 (Unpublished document) Australia, Commonwealth Bureau of Census and Statistics (1958) Official year book of the Commonwealth of Australia, Part VII. Population, vital statistics and housing, Canberra Australia, Commonwealth Bureau of Census and Statistics (1961) Australian demo ra hic review, (i) Marriages, 1960 (ii) Births, 1960 iii Deaths, 1960 (iv) Divorces, 1960 (v) Population and vital statistics, 1960, Canberra Australia, Commonwealth Bureau of Census and Statistics (1961) Coding instructions for vital statistics, New South Wales (Unpublished documents ) Australia, Commonwealth Bureau of Census and Statistics (1958) International statistical classification of diseases, injuries and causes of death, 1955 Revision, (Booklet for the guidance of medical practitioners in filling up the medical certificates of cause of death), Canberra Australia, New South Wales Registrar-General's Department (1961) Specimen copies of registration and statistical forms for marriages, births, deaths, medical certificate of cause of death, burial permit and infectious diseases notifications in use in New South Wales, Sydney Australia, Commonwealth Bureau of Census and Statistics (1961) Specimen copies of vital statistics compilation sheets for Australia, Canberra Fiji, Registrar-General's Department (1961) Annual report for the year 1960, Suva Fiji, Medical Department (1961) Annual report of the Medical Department for the year 1960, Suva Hemmi Bamboo Slide Rule Hfg. Co., Ltd (1958) Brief instruction for the use of the "Hemmi" bamboo slide rule, (For use of Model No.40 RK slide rule given to trainees), Tokyo Hemmi Bamboo Slide Rule Mfg. Co., Ltd (1958) Instruction book for the use of "Hemmi" bamboo slide rule (Mannheim t (For use of Model No.40 RK slide rule given to trainees , Tokyo
(4)
(5)
(6)
(7)
(8) (9)
•
(10) (11)
(12)
- 20 ANNEX II
(13) (14) (15) (16) (17) (18) (19)
Hill, A.B. (1961) Principles of medical statistics, 7th ed.,London New Zealand, Department of Health (1960-1961) Special report series Nos. 1, 4 and 5, Wellington New Zealand, Department of Health (1955) Accounting for sickness and death, Wellington New Zealand, Department of Health (1961) Students' notes on health statistics (Unpublished document) New Zealand, Department of Health (1959) Mental health statistics handbook, Wellington New Zealand, Department of Health (1961) Morbidity survey: of &eperal pract it i,oners, Wellington College
•
•
New Zealand, Department of Health (1961) Specimen cards: (a) cancer statistics cards (b) punched cards (c) mental health statistics cards, Wellington Nielsen, K.J. (1961) Logarithmic and trigonometric tables, 2nd ed., New York Quo, S.K. (1959) Re ort on field visit to Australia 7 to 18 March and 24 March to 1 April 1959 Unpublished working document WPR/STAT/FR/7, Rev.l) Quo, S.K. (1959) Re ort on field visit to New Zealand 1959 (Unpublished working document WPR 18 to 24 March
(20) (21)
(22) (23)
Swaroop, S. (1960) Introduction to health statistics, for the use of health officers, students, public health and social workers, etc., Edinburgh United Nations, Statistical Office (1960) Demographic yearbook, 1959, New York United Nations, Statistical Office (1954) Handbook of statistical organization, (Studies in Methods Series F, No.6, document ST/STAT/SER.F/6), New York United Nations, Statistical Office (1955) Handbook of vital statistics methods, (Studies in Methods Series F, No.7, document ST/STAT!SER.F/7), New York United Nations, Statistical Office (1953) Principles for a vital statistics system, (Statistical Papers Series M, No.19, document ST/STAT/SER.M!19), New York
(24) (25)
•
(26)
(27)
- 21 ANNEX II
• •
(28) (29)
United States of America, United States Public Health Services (1958) Physicians' handbook on death and birth registration, Washington,D.C. World Health Organization (1957) Manual of the international stati8~ical classification of diseases, injuries and causeS of death, Vol. I, Based on the recommendationsof the Seventh Revision Conference, 1955, and adopted by the Ninth World Health Assembly under the WHO Nomenclature Regulations, Geneva World Health Organization (1957) Manual of the international statistical classification of diseases, injuries and causes of death, Vol. II, Based on the recommendations of the Seventh Revision Conference, 1955, and adopted by the Ninth World Health Assemb~ under the WHO Nomenclature Regulations, Geneva World Health Organization (1958) Medical certification of cause of death, Instructions for physicians on use of international form of medical certificate of cause of death, 2nd ed., Geneva
•
(30)
•
(31)
•
- 22 ANNEX III
LIST CF BOOKS AND DOCUMENTS IN REFERENCE LIBRARY A.
•
. Fran Australia (1) (2) Australia, Commonwealth Bureau of Census and Statistics (1961) Demography bulletin, 1959, Canberra Australia, New South Wales Office of Commonwealth Bureau of Census and Statistics (1961) Population and vital statistics for New South Wales, Sydney Australia, Commonwealth Bureau of Census and Statistics (1957) Pro·ection of the 0 ulation of Australia 1955 to 1975 at five yearly intervals Unpublished document (4) Australia, Commonwealth Bureau of Census and Statistics (1960) Official year book of the Commonwealth of Australia, No.46. Bart IV. PopUIat10n. V1tal stat~t1cs, hous1ng and other new building, Canberra
..
B.
From New Zealand (1) (2) (3) (4) (5) (6) (7) (8) American Medical Association (1942) Standard nomenclature of diseases, Chicago Benjamin, B. (1959) Elements of vital statistics, London New Zealand, Department of Statistics (1960) Pocket digest of New Zealand statistics, Wellington New Zealand, Department of Health (1947) The medical practitioner and the state, Wellington New Zealand, Department of Statistics (1960) New Zealand official year-book. Wellington New Zealand, Department of Health (1958) Annual report on the mental health statistics of New Zealand, Wellington New Zealand, Department of Health (1958 & 1959) Annual report on the medical statistics of New Zealand, Wellington New Zealand, Department of Health (1955) Report on cancer morbidity and mortality in New Zealand. Wellington
- 23 -
ANNEX III (9) (10) (11) New Zealand, Department of Statistics (1961) Monthly abstract of statistics, November, Wellington New Zealand, Department of Statistics (1961) Report on population, migration and building statistics, 1959-1960, Wellington New Zealand, Department of Statistics (1960) Report on the vital statistics of New Zealand, 1959, Wellington New Zealand, Department of Health (1959) Maori infant mortality pamphlet, Wellington
..
(12)
.
C.
From WHO Regional Office for the Western Pacific (1) (2) (3) Benjamin, B. (1959) Elements of vital statistics, London Cochran, W.G. (1953) Sampling techniques, New York Comrie, L.J. (1958) Barlow's tables of squares, cubes, square roots and reciprocals of all integers up to 12 500, 4th ed., London Edge, p.G. (1947) Vital statistics and public health work in the tropics, including supplement on the genealogy of vital statistics, London Hall, M.F. (1949) Public health statistics, 2nd ed., New York Hansen, M.H., Hurwitz, W.N. & Madow, W.G. (1953) Sample survey methods and theory, Vol. I, Methods and applications, New York McArthur, N. (1961) Introducing population statistics, Melbourne Schmid, C.F. (1954) Handbook of graphic presentation, New York Scragg, R.F.R. (1957) Depopulation in New Ireland, a study of demography and fertility, Port Moresby Spear, M.E. (1952) Charting statistics, New York United Nations, Department of Economic and Social Affairs (1958) Multilingual demographic dictionary, prepared by the Demographic Dictionary Committee of the International Union for the Scientific Study of Population, English Section, New York United Nations, Department of Social Affairs (1954) Foetal, infant and early childhood mortality, Vol. I, The statistics (Document ST/SOA/Series A/13), New York
(4)
•
(5)
(6) (7)
•
(8) (9)
•
(10) (11)
(12)
- 24 ANNEX III
(13)
United Nations, Department of Social Affairs (1954) Foetal, infant and ear childhood mortalit , Vol. II, Biological, social and economic factors Document ST/SOA/Series A/13, Add.l), New York
•
(14) countries (15) United Nations, Statistical Office (1952) Report on the international training centre on vital statistics and health statistics for South-East Asia, held at Nuwara EILya, Ceylon, from 19 September to 11 December 1951 (Statistical Papers Series M, No.12, document ST/STAT/SER.M/12), New York United Nations, Statistical Office (1953) Report on the Western Pacific Regional seminar on vital statistics and health statistics, held in Tokyo, Japan, from 4 August to 20 September 1952 (Statistical Papers Series M, No.15, document ST/STAT/SER.M/15), New York United Nations, Statistical Office (1955) Report on the training centre on vital and health statistics, held in Kabul, Afghanistan, from 13 September to 24 October 1954 (Statistical Papers Series M, No. 24 document ST/STf.T/SER.M/24), New York United States, Department of Health, Education amd Welfare (1956) Health and demography, prepared by Halbert I. Dunn, Chief, NationalOffice of Vital Statistica, Department of Health, Education, and Welfare, Public Health Service, National Office of Vital Statistics, Washington, D.C. World Health Organization (1956) Report on African seminar o~~ and health statistics, Brazzaville, 19-24 November 1956 (Unpublished document CC/vffiO/Stats. Sem./35, Rev.l; document WHO/HS/85,7.12.'56) World Health Organization (1957) Epidemiological and vital statistics report, perinatal mortality, Vol. 10, No. 11-12, Geneva World Health Organization (1959) Annual epidemiological and vital statistics, 1956, Geneva World Health Organization (1960) Annual epidemiological and vital statistics, 1957, Geneva World Health Organization (1961) Annual epidemiological and vital statistics, 1958, Geneva Yates, F. (1953) Sampling methods for censuses and surveys, 2nd ed., London Yule, G.U. & Kendall, M.G. (1953) An introduction to the theory of statistics, London
•
(16)
(17)
(18)
(19)
(20)
•
(21) (22) (23) (24) (25)
- 25 ANNEX IV
SYUABUS 1. Vital Statistics 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 2. Needs and uses of vital statistics in public health administration Sources of vital statistics Organization of a registrati8n system Definition of registrable vital events Organization of a vital statistics service Compilation of vital statistics Rates and ratios used in vital statistics Standardization of rates Evaluation of vital statistics Estimates of population Life tables
.
Health Statistics 2.1 2.2 2.3 2.4 Needs and uses of health statistics in public health administration Sources of health statistics Organization of a health statistics service Statistics of causes of death 2.4.1 2.4.2. Medical certification of causes of death The International Statistical Classification of Diseases, Injuries, and Causes of Death, 7th ReVision, 1955 Coding rules and their application
2.5
Morbidity statistics 2.5.1 2.5.2 2.5.3 2.5.4 2.5.5 2.5.6 Hospital morbidity statistics Dispensary m8rbidity statistics Statistics of communicable diseases General morbidity surveys Specific disease surveys Specific disease registers
•
•
2.6 2.7 2.8 2.9
Health service statistics Statistics of sanitary conditions Rates and ratios used in health statistics Statistical content of annual health reports
- 26 ANNEX IV
Syllabus (cont'd)
3.
Statistical Methods
3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 4.
Collection of data Tabulation Computation Use of logarithms, slide rules and calculating machines Frequency distribution Tabular and graphic presentation Mean, median and mode Standard deviation Coefficient of variation Measurement data Standard error of the mean Comparison of means Enumeration data Standard error of proportion Comparison of proportions Sampling Special topic: Chi-square test
•
Visits to operating agencies
•
.
.
- 27 -
ANNEX V
TIMETABLE OF THE COURSE
. Date Time Subjects Arrival of Trainees Registration Tea Break Issue of Documents Official Opening Lunch Introductory Talk Study Period Needs and Uses of Health Statistics Tea Break Sources of Health Statistics Lunch Needs am Uses of Vital Statistics Study Period Collection of Data Tea Break Tabulation Lunch Basic Forms for Health Statistics Study Period Sources of Vital Statistics Tea Break Organization of a Registration System The Registration System of Fiji Lunch Field Trip. Visit to Registrar-General's Department Study Period Computation Tea Break Use of Logarithms, Slide Rules and Calculating Machines Lunch Mechanical Aids and Use of Punched Cards Study Period Lecturer
8.1.62 •
09.00 10.30 10.45 12.00
. 9.1.62
Dr. A.R. Edmonds Dr • S.K. Quo Dr. Quo
12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 11.30 12.30 13.30 16.00 12.1.62 09.00 10.30 10.45 12.30 13.30 16.00
Mr. C.E. Gardiner Mr. Gardiner Mr. E.H. Harry Dr. Quo
10.1.62
Dr. Quo Mr. Gardiner Mr.- Harry Mr. Harry
•
11.1.62
•
Mr. B.L. Gregg Mr. M.T. Khan
.
Dr. Quo Dr. Quo Mr. Gardiner
- 28 ANNEX V
Date
Time
Subjects Definition of Registrable Vital Events Tea Break Organization of a Vital Statistics Service Lunch Discussion of Model Instructions to Vital Statistics Officers Study Period Tabular and Graphic Presentation Tea Break Frequency Distribution Lunch Field Trip. Visit to Medical Department Study Peri od The Death Certificate Tea Break Classification of Causes of Death Lunch Practical Exercises on Causes of Death Study Period Mean, MediaD and Mode Tea Break Mean, Median and Mode (cont'd.) Lunch Compilation of Vital Statistics Study Period
Lecturer
•
15.1.62
09.00 10.30 10.45 12.30 13.30 16.00
Mr. Harry
Mr. Harry •
Mr. Harry Dr. Quo Dr. Quo Mr. G.E. Martin
16.1.62
09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 15.00 16.00 09.00 10.30 10.45 12.30 13.30 16.00
17.1.62
Mr. Gardiner Mr. Gardiner Mr. Gardiner
18.1.62
Dr. Quo Dr. Quo
•
Mr. Harry
19.1.62
Mr. Harry Rates and Ratios used in Vital Statistics Tea Break Mr. Harry Standardization of Rates Lunch Organization of a Health Statistics Service Mr. Gardiner Mr. Martin Health Statistics in Fiji Study Period Standard Deviation Tea Break Coefficient of Variation Lunch Measures of Fertility Study Period Dr. Quo Dr. Quo Mr. Harry
22.1.62
- 29 ANNEX V
Date
Time
Subjects
Lecturer
23.1.62
09.00 10.30 10.45 12.30 13.30 16.00
Morbidity Statistics Mr. Gardiner Tea Break Special Health Statistics Mr. Gardiner Lunch Slides illustrating the Graphical Presentation of Health Statistics Mr. Gardiner Study Period Measurement Data Tea Break Standard Error of the Mean Lunch Evaluation of Vital Statistics Study Period Spec ilic Disease Surveys Tea Break Specific Disease Surveys (cont 'd.) Lunch Comparison of Means Study Period Dr. Quo
..
24.1.62
09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 1.0.45 12.. 30 B.30 l6.oo
Dr. Quo Mr. Harry Mr. Gardiner
25.1.62
Mr. Gardiner Dr. Quo
•
26.1.62
Censuses of Population Mr. Harry Tea Break Estimates of Popul at ion Mr_. Harry Lunch Pract ical Exerc ises on Population Statistics Mr. Harry Study Period Enumeration Data Tea Break Standard Error of Proportion Lunch Basic Mortality and Morbidity Rates Study Period Life Tables Tea Break Life Tables (cont'd.) Lunch Comparison of Proportions Study Period Dr • Quo Dr. Quo Mr. Gardiner
•
29.1.62
•
30.1.62
Mr. Harry Mr. Harry
Dr. Quo
- 30 ANNEX V
Date
Time
Subjects
Lecturer
31.1.62
09.00 10.30 10.45 12.30 13.30 16.00 09.00 10.30 10.45 12.30 13.30 16.00
Annual Report for a Health Department Mr. Gardiner Tea Break Annual Report for a Health Department (cont 'd) Mr. Gardiner Lunch Revision Paper on Vital Statistics Mr. Harry Study Period Sampling Tea Break Sampling (cont'd.) Lunch Discussion Groups - Summary of Work on Health Statistics Study Period Chi-square Test Tea Break Summing up on Statistical Methods Lunch Completion of WHO Questionnaires Individual Discussion with Lecturers Closing Session Tea Party given by Fiji Government Dr. Quo
1.2.62
Dr. Quo Mr. Gardiner Dr. Quo Dr. Quo
.
2.2.62
09.00 10.30 10.45 12.30 13.30 15.30 16.00
Dr.W.H. McDonald Dr. Quo
•
•
- 31 ANNElC VI CONTENTS OF L:&;TURES • 1.
VITAL STATISTICS Needs and uses of vital statistics in public health administration For the administrative and research needs of public health agencies For the demographic analysis of population for economic and social purposes For determining administrative action in connection with the programme of governmental agencies other than those connected with public health They are also useful to individuals and as elements in research Sources of vital statistics From the registration system From hospital records of births and deaths From isolated reports from mission stations, trading posts or government patrols
1.1
•
1.3
Organization of a registration system Minimum requirements for a registration system Minimum requirements for registration of births, deaths and marriages Qualifications for registrars Checking of registrations Types of registers and specimen forms used
•
1.4
Definition of registrable vital events United Nations standard definitions of: Live births, deaths, foetal deaths, marriages, divorces, etc. adoptions, legitimations and other recognitions Illustrations - Australia and other countries
• 1.5
Organization of a vital statistics service Collection of data Editing of data Classification and computing Tabulation
- 32 ANNEX VI
1.6
Compilation of vital statistics Minimum general goal recommended by United Nations Tabulation programme Compilation methods - manual and mechanical Specimen forms used - Australia and other countries •
1.7
Rates and ratios used in vital statistics Difference between rates and ratios Crude birth, death, marriage, etc. rates Specific rates - age-specific and age-sex specific
1.8
Standardization of rates Standardized birth and death rates Age-specific fertility rates Gross and net reproduction rates True death rates
1.9
Evaluation of vital statistics Quantitative accuracy of registration Quantitative accuracy of statistical reporting Qualitative accuracy The degree of success achieved by the tabulation programme
1.10
Estimates of population Census taking Linear interpolation for periods between censuses Post-censal estimates By extrapolation of linear trend y = ax + b x By extrapolation of exponential curve y = ab By application of annual natural increase and net migration to census records Estimates made by building up estimates from isolated points Need for care in using estimates
•
1.11
Life tables Definition of a life table Brief outline of method of construction of an abridged life table Explanation of elementary values and symbols Interrelation of life table values
1.12
Revision paper on vital statistics
- 33 ANNEX VI
2.
HEALTH STATISTICS Needs and uses of health statistics Purposes of medical statistics: For public health purposes For medical science For various social needs Need for statistics in a health department Special uses of health statistics Need for detailed studies on health statistics Early history of vital and health statistics, covering mortality and morbidity statistics, hospital statistics, notifications of diseases Sources of health statistics
2.1
• 2.2
Basic forms for health statistics Collection of primary data and sources of material Preparation of statistical material for processing Presentation of statistics in tabular form - construction of tables Publications - methods of publication and standard health statistical publications as prepared in New Zealand Interpretation of health statistics, and in particular of the health and medical statistics of New Zealand
2.3
Mechanical aids and use of punched cards Elementary methods of counting from schedules, forms, cards, registers, etc. Hand sorting and counting Marginal punched card system with demonstration or prepared cards and equipment Description of the use of various types of mechanical punched card systems
2.4 2.4.1
The death certificate The death certificate
Classification of causes of death
Description and interpretation of International Medical Certificate of Causes of Death Refinements of the standard certificate to allow for post-mortem reports, queries of inaccurat-e statements, etc. Development of design of medical certificate from elementary form to present proviSion for statement of underlying cause of death. Doctor's responsibility in preparing certificates Foetal death certificate and proposal for improvement in foetal and nea-natal death certificate
- 34 ANNEX VI
2.4.2
Classification of causes of death Needs for a statistical classification of causes of death Purposes of the classification Historical review of origin of statistical classification of causes of death Development of International Classification - historical periodical reviSion, etc. change to inclusion of morbidity claSSification Structure of the Intern2tional Statistical ClaSSification (Seventh Revision) Uses of Detailed, Intermediate and Short Lists, and Classifications for Special Purposes (Stillbirth, E & N Classifications lor Accidents and Injuries, etc.) Obligations under W.H.O. Regulations Rules for classificatiJn of causes of death and coding Nomenclature of disease
•
2.5
Organization of a health statistics service Morbidity statistics Need for and importance of morbidity statistics Historical developments Problems in the collection of sickness data, definition, scales of ill-health, diagnosis and criteria of ill-health Morbidity terminology Sources of morbidity statistics Morbidity rates Hospital statistics
2.6
2.7
Special health statistics Child Health Statistics Pharmaceutical Statistics Census of hospital in-patients (I~-3-study) Statistics of communicable diseases Statistics of sanitary conditions Study of infectious hepatitis in New Zealand Special period devoted to illustrated talk on graphical presentation with interpretation of the data represented
.
2,8
Specific disease surveys How to design and inaugurate special disease survey Description of, and discussion on, the preparation and carrying out of the following special disease surveys conducted in New Zealand in recent years
- 35 -
ANNEX VI Maori infant-mortality with special reference to living conditions Smoking habits of school children Maori-European standards of health Survey of morbidity experienced in general medical practice 2.9 Basic mortality and morbidity rates Foetal deaths and infant mortality - ear~ neo-natal, pari-natal, post-natal Appropriate foetal and infant mortality rates for above Standardized death-rates Incidence, prevalence and case-fatality rates 2.10 Annual report far a health department Design of a standard Report based on Annual Report of the New Zealand Department of Health, 1960-61 Detailed description of various sections of the Report Statistical tables for departmental report 2.11
•
•
Discussion groups - Summing up on health statistics Selected topics from the various lectures on health statistics for individual discussion by participants Question time for answering problems encountered by participants in the practical tests set during the Course
3.
STATISTICAL METHODS Collection of data Methods of collection: Enumeration Registration Survey (questionnaires) Hospital records Health service records Experiments and observations Scrutiny :f CJllcctcd ct1tCl Lor adequacy, completeness and accuracy
3.1
•
•
- 36 ANNEX VI
3.2
Tabulation Gr:)uping: Number of groups Group interval Tally Cards Marginal punch cards Mechanical punch cards Exercises
•
•
3.3
Computati:)n Simple arithmetic Exercises
3.4
Use:)f logarithms, slide rules and calculating machines Logarithms and antilogarithms: Multiplicntion Division Powers Ro:)ts Slide Rules: Multiplication Divisi:m Squares Square r:)ots Cubes Cube r:):)ts L:)garithms Ant ibgarithms Successive multiplicati:)n Successive division Combination of multiplication and division C:)mbined multiplication and diVision including squares and square roots Multiplication and division including cubes and cube r:)ots C:)nversi:m Proportional allotment
•
•
- 37 ANNEX VI Calculating machines: Addition Subtraction Multiplicatbn Division Accumulative multiplication Negative multiplication Other compound operations Proportional allotment Square roots Exercises
•
•
3.5
Tabular and graphic presentation Construction of statistical tables Construction of diagrams Kinds of diagrams: Line graphs: arithmetic scale logarithmic scale Bar diagrams Histograms Frequency polygons and frequency curves Scatter diagrams Haps Pie diagrams Pictographs Exercises
3.6
Frequency distribution Types of frequency distribution Normal curve
•
3.7
Mean, median and mode Arithmetic mean Weighted mean
•
Median Mode Calculations from ungrouped figures Calculations from grouped figures Exercises
- 38 ANNEX VI
3.8
Standard deviation and coefficient of variation Variability of observations Range Mean deviation Standard deviation Coefficient of variation Calculation of standard deviation: from ungrouped figures from grouped figures Exercises
•
•
•
3.9
Measurement data am standard err:)r of the mean Sampling distribution of means Standard error of the mean Concept of universe Confidence icterval Exercises
3.10
Comparison of means Sampling distribution of differences between means Standard error of differ0nce between means Null hypothesis Test of significance of difference between means Exercises
3.11
Enumeration data and standard error of proportion Sampling distribution of proportions Standard error of proportion Confidence interval Exercises
3.12
Comparison of proportions Sampling distribution of differences between proportions Standard error of difference between proportions Test of significance of difference between proportions Exercises
- 39 ANNEX VI
•
3.13
Sampling Objects of sampling Methods of sampling: Sampling units Simple random sampling Random sampling numbers Systematic sampling Stratified sampling Multi-stage sampling Standard error of estimates Confidence intcrv~l Size of sample Exercises
•
• 3.14
Special topic Chi-square test Exercises
3.15
Summing up on statistical methods
..
- 40 -
ANNEX VII INDIVIDUAL EVALUATION QUESTIONN;'IRE NO.1
•
• This questionnaire has been prepared f~r the purpose of assessing, on an individual basis, the administrative aspects of the training course as an aid in the planning and operation of future meetings of this nature. Please check the appropriate statements and write your comments legiblY. Since this form is to be unsigned, your frank criticisms, suggestions and comments are cordially invited. 1. 2.
Travel arrangements were: Excellent 10* Satisfactory Physical arrangements of the site of the training course were: Excellent Accommodation and services were: Excellent The amount of free time available for personal matters and rest was: Adequate
4
Reasonably SAtisfactory
2..
Unsatisfactory
1
.,
Unsatis9 Adequate 2
Fairly
go~d
6 factory Unsatisfactory
5
3.
4
Adequate
4
Reasonably good
4
8
4.
5
Just en:Jugh
Not 8 enough
9
More than enough
o
5.
The total length of the training Very course was: Satisfactory 1 Satisfactory 7
Too short
14 Too long
0
6.
The schedule of the training Very course was: Satisfactory 8 Satisfactory 6 Too crcwded The working hours were: Very Satisfactory 8 Satisfactory 12 Too short Of some help
8 Too loose 0 2 Too long 0
7. 8.
The information bulletins and Very circulars were: helpful Library and reference facilities were: Adequate
19
Helpful
2
1
Of little help 0
9.
17
Just right
5
Limited
o
Poor
0
*
The figure in each case denotes the number of responden~who checked the statement concerned
- 41 -
ANNEX VII
• 10.
•
Documentation to cOlTer the subject matters were: Elccellent Opportunities to become acquainted with other trainees and staff were: Ample
20 Satisfactory
2 Fairly good
0
Poor
0
11.
• • 12.
10
Just enough
6
Not enough
6
None at all 0
The leadership of the training dourse was: Elccellent 19 Wh~t
Satisfactory
2-
Fairly good
0
Poor
0
13.
improvements would you suggest for future meetings of this nature?
14.
Comments.
•
- 42 -
ANNEX VIII
. INDIVIDUAL EVALUATION QUESTIONNAIRE NO. 2
• This questionnaire is intended to assess th~ achievements of the training course on an individual basis. You are kindly requested to check the appropriate statem8nts and write legibly your frank opinion and comments. Your criticisms and suggestions are cordially invited. Please do not sign your name. 1.
Were you interested in this training course? Very much Did you gain any new ideas or concepts? enough opportunity to express your own ideas in the cla ss?
.;
22
'.1-
Quite abH
0
To some extent
Very 0 little
0
2.
i'1any
18
Some
4
None Very few Q at all
0
3. Did you have None at all
Ample
12
Just enough
5 Not enough
~
1
4.
Did you have enough opportunity to exchange knowledge ar.d experience with other trainees and staff outside the class?
• ~ple
10 Just enough 4
Not enough 8
None at all 0
5.
Each of you came with specific objectives ~md expectations. To what extent do you feel these have been attained? Completely 4 For the most part 15 Some 3 A little (If the answe-r i" either "Some" or"A little ll , please give further details.) The scope of study Just Too and discussion was: Adequately covered 8 right 10 large The training course has been to you: Highly valu:lblo 16 Valuable 4
o
6. 7.
~
Too small
2
Of some V'llue 1
Of little value 0
•
*
The figure in each case denotes the number of respondents who checked the statement concerned.
- 43 -
ANNEX VIII
• •
8. 9.
Would you be willing to respond to a follow-up questionnaire about the training course to be sent to you one year from now? Yes 22 No 0 What do you consider were good features in the content of the training ~ourse?
10 •. What features do you consider were not so good? 11. 12.
How will this training course be reflected in your plan for development and improvement of vital and health statistical services in your country? Comments •
•