The AIDS Programme Effort Index (API)
The AIDS Programme Effort Index is a composite index designed to measure political commitment and programme effort in the areas of HIV prevention and care. It tries to capture many of the inputs and outputs of a national HIV/AIDS programme. The score is made up of 10 main components of an effective national response: political support, policy formulation, organisational structure, programme resources, evaluation and research, legal and regulatory aspects, human rights, prevention programmes, care programmes and service availability.
The API uses key informants from a designated mix of institutions to give opinions about central areas of commitment and programming, compiling an index out of scores given in various areas. The score, which is calculated as a percentage with zero indicating no programme effort and 100 indicating maximum effort, may be converted into a grade to minimise informant variation. Suggested grades range from very weak and weak through moderate and strong to very strong, depending on the range in which the numerical scores fall.
Every 2-3 years
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
The major concern surrounding the API is its subjectivity and its reliability. The outcome depends entirely on the choice of informants and informants will likely change from year to year. Since the indicator is still under development, the choice of informants has not yet been standardised. Questions have also been raised about the utility of a single composite score, in which improvements in some areas may be masked by deterioration in other areas. For diagnostic as well as monitoring purposes, it may be more useful simply to publish the indices separately by category. The separate category scores may stand alone as indicators, although for several areas of programme effort this document proposes alternatives which are based on measured parameters rather than expert opinion and may therefore be more useful in tracking trends over time. One area in which the API process may yield a particularly useful indicator is in the area of policy formulation (Section 20 of the API protocol).