Districts with VCT services
This is another measure of coverage, but focuses more particularly on coverage of specialised VCT services.
Number of districts with at least one facility meeting the criteria
Total number of districts
Using key informants and health systems records of counsellor training, a list is constructed of all facilities offering counselling by trained counsellors and HIV testing services. Since the object is to get an idea of accessibility of counselling and testing services, all specialised services that are open to and accessible to most members of the general public should be included, whether public, private or nongovernmental. This will include VCT services that are integrated into hospital or primary health care services. It may, however, exclude those attached to services with limited clientele such as antenatal clinics or STI clinics. Since price is a major part of accessibility, this should be considered in formulating this indicator. A suggested formula is the price of voluntary counselling and HIV testing does not exceed one half of the daily minimum wage, or one half of the gross national product per person per day, calculated at purchasing power parity. Low or affordable prices may vary by district, and thus the measures should be adjusted. A further criterion is that the staff actually providing counselling are trained. Where a country has specified minimum standards of training for counsellors, staff providing counselling should meet these standards of training. Facilities meeting the criteria for service provision, staff training and price are mapped by district or similar administrative unit. The indicator is the percentage of all districts in the country with at least one facility meeting the criteria. Since districts (or similar administrative units) are usually defined in relation to their population size, weighting of the indicator is considered unnecessary.
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
The indicator gives a crude idea of coverage of VCT services. It is most useful in tracking changes over time as a national programme attempts to scale service provision up to meet need in a generalised epidemic. Once coverage has reached a certain level, it is unlikely to fall again and the indicator becomes obsolete. A major limitation of the indicator is that it does not take into account the scale of the epidemic (and therefore the scale of potential need for VCT). It is not appropriate for use in low-level or concentrated epidemics. In those situations, VCT services will be more efficiently used if they concentrate on providing for the needs of populations with higher than average risk behaviour.