Proxy indicator for accessibility and utilization of health services that may reflect the quality of services. It does not measure the coverage of this service, but the average number of visits in a defined population.
The number of visits to health facilities, i.e. all public and private health facilities and mobile clinics, for ambulant care in a defined administrative or health area during a year
The total population for the same administrative or health area
Administrative area; health area; age; sex; support/no support from humanitarian organisations;
Indicator used for response monitoring ?
Threshold / Standard
> = 1 new visit/person per year Follow-up of trends
Calculation: The numerator is defined as the number of visits to health facilities for ambulant care, not including immunization (can be divided into children under five years of age and aged five years and over); The attendance rate is usually calculated annualy. It can be used, nevertheless, to monitor the monthly evolution. In that case, the denominator (target population) should be divided by 12 for keeping the same unit. Interpretation: the patient volumes at outpatient facilities are not a coverage indicator because the population in need is not well defined. Low rates, however, are indicative of poor availability and quality of services. For example, several countries have demonstrated that outpatient department rates go up when constraints to using health services are removed, such as by bringing services closer to the people or reducing user fees. In contrast, once rates exceed a certain threshold the number of visits is no longer an indicator of the strength of the health services.
Guidance on phases
There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...
Numerator: routine health facility reporting system; Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health areas;
Further guidance: Monitoring the building blocks of the health (http://www.who.int/healthinfo/systems/monitoring/en/index.html)