Existence of guidelines for the prevention of HIV infection in infants and young children
The indicator identifies whether guidelines exist that are in line with international or commonly agreed standards.
National guidelines are commonly based on existing international standards or on standards about which there is general agreement but which have not yet been formally presented as international guidance. Without guidelines, services of unknown quality and impact could be implemented on an ad hoc basis, making it difficult to monitor and evaluate efforts.
What is covered by policies and guidelines for the prevention of HIV infection in infants and young children? The prevention of initial infection among HIV-negative women; the prevention of unintended pregnancies among HIV-positive women; ARV prophylaxis; safe delivery practices; counselling and support for infant feeding among HIV-infected pregnant and lactating women; and referral or provision of care and support for HIV-infected women and their children. Whatever components of prevention and care are ultimately adopted, countries should adapt their guidelines to their particular circumstances.
A survey among key informants at the national level or in health care facilities is used to determine whether there are guidelines for each intervention prong. The key informants in this situation at the national level are the persons responsible for HIV/AIDS, maternal and child health or infant feeding and nutrition. At the health facility level the key informants include practitioners and clinic directors. When enquiries are being made as to whether such guidelines exist the following additional questions may be asked if time and resources allow.
• How were the guidelines formulated? (Explore the process: ask by whom and on what basis they were formulated.)
• Are the guidelines nationally accepted (even if only draft versions are available)?
• To what extent are they implemented? (Explore the extent of implementation and the barriers and opportunities that were or are being encountered in implementation.)
• How often and by whom are they updated? The indicator should be measured and the above questions answered for each intervention as outlined in the indicator’s definition.
This indicator should be measured every year until guidelines are found to exist.
Condom type: N/A
Geographic location: N/A
HIV status: N/A
Pregnancy status: N/A
Service Type: N/A
Time period: N/A
Type of orphan: N/A
Type/Timing of testing: N/A
Vulnerability status: N/A
This indicator is not concerned with the quality of guidelines or that of their implementation. Furthermore, because it does not capture new developments in the field, the guidelines have to be reassessed periodically in order to guarantee that they remain consistent with changing standards.