Antenatal clinics offering or referring for VCT

Export Indicator

Percent of clients at public antenatal clinics that attend clinics offering counselling and voluntary testing for HIV by trained staff, or referring to VCT services
What it measures

While the previous measure, Pregnant women counseled and tested for HIV, gave an idea of coverage of counselling and voluntary testing among pregnant women in the population, this indicator gives an idea of the proportion of public ANC clinics in the country that are offering the service. That is, it gives some idea of the extent to which the national programme is able to scale up interventions begun on a pilot basis. It should reflect efforts to expand prevention services for pregnant women more quickly than the population-based measure given by Mother to Child Transmission Indicator 1, Pregnant women counselled and tested for HIV.

Rationale
Numerator

Number of clients in the past year attending antenatal clinics offering voluntary testing for HIV and post-test counselling by trained staff (or referring to other services)

Denominator

Total number of women attending antenatal clinics surveyed in the past year

Calculation
Method of measurement

In a health facility survey, randomly selected public antenatal clinics are visited. Staff interviews and record reviews are conducted to ascertain whether any of the clinic staff are trained in counselling, and whether the clinic routinely counsels clients about HIV in pregnancy and offers HIV tests with post-test counselling or refers clients to qualified outside services. The annual client volume of the clinic is also recorded. The indicator is weighted by client volume: the number of clients in the past year attending antenatal clinics offering voluntary testing for HIV and post-test counselling by trained staff (or referring to other services), divided by the total number of women attending antenatal clinics surveyed in the past year.

Measurement frequency
Disaggregation

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

Private sector clinics will often take the lead in providing services for those HIV-infected pregnant women who can afford to pay for interventions. Because such interventions are relatively expensive, the goal of national programmes is to extend their reach to less affluent members of society, through service provision in public facilities. It is therefore recommended that this indicator be confined to measuring service provision in public sector clinics. However, countries that are making an effort to increase training in counselling for staff at antenatal clinics in the private sector or among traditional birth attendants may want to include such groups in this indicator. Ideally, this measure would include all public antenatal services in a country. Since this is likely to be impractical, sampling is adopted. However, clinics are likely to counsel all patients or none, so the profile of the clinics sampled will have a potentially huge effect on the indicator, and changes may be difficult to interpret over time. This indicator is most useful in countries that are actively expanding coverage of maternal to child prevention services. A steady rise in the indicator is likely to reflect a steady expansion of service provision. However if sampling is necessary, the indicator may be slow to reflect progress.

Further information