(HRH_STAFF) Number of health worker full-time equivalents who are working on any HIV-related activities i.e. prevention, treatment and other HIV support at PEPFAR-supported facility sites

Export Indicator

Number of health worker full-time equivalents who are working on any HIV-related activities i.e. prevention, treatment and other HIV support at PEPFAR-supported facility sites
What it measures

Definition

This indicator is the number of full-time equivalent positions (FTE) working on HIV (“HIV FTE”) at PEPFAR facility sites. Calculate part-time positions working exclusively on HIV, or full-time positions working on several areas including HIV and other illnesses, as fractions, based on hours worked relative to full-time equivalency hours. Full time equivalency hours should be the standard listed in the cadre’s scheme of service and/or Ministry of Health guidelines.

This is NOT a cumulative total, but a one-time count undertaken during the final quarter. Only filled staff positions at respective facility should be counted. A “PEPFAR supported site” for the purpose of this indicator should include any facility site in the PEPFAR geographic organizational hierarchy list in DATIM, which also reported any sitelevel programmatic target or result during the same reporting period.

Omit community sites. Omit facilities which were previously supported by PEPFAR, but were not assigned any targets nor reported any results for any program area during the same reporting period.

Include all health care workers irrespective of whether any or all are receiving PEPFAR support (this is captured in HRH_CURR.)

How to use:

HIV/AIDS has placed significant demands on the already constrained health workforce in many low-income countries. The rapid scale-up of ART is placing additional demands on the health workforce.

In the majority of PEPFAR countries, there are overall shortages of HRH, particularly in rural and remote areas, leading to insufficient numbers of health workers according to internationally recommended levels (2.3 doctors, nurses, midwives/1,000 population). Many countries experience HRH shortages and/or imbalances by population densities (e.g., HRH shortages in rural areas) that are not related to population health needs, including HIV epidemiology. Addressing density, distribution, and overall utilization of HRH is important in increasing access to HIV services.

This indicator allows PEPFAR to analyze the availability of staff to provide HIV services at PEPFAR supported facilities. Data should be reviewed against site target achievement and investment. The first year of data collection will serve as an Integral benchmark for continued analysis.

Teams can also look at this indicator in conjunction with HRH_CURR that captures number of PEPFAR supported workers at PEPFAR-supported sites. This will allow PEPFAR to conduct analysis to determine if the number of PEPFAR-supported staff is appropriate vis-à-vis the number of other staff at the facility providing HIV services.

There is no universal benchmark against which to measure these data and no ideal PEPFAR to non-PEPFAR ratio. However, over time we would hope to see a decrease in the number of PEPFAR-supported staff. As this happens countries should carefully monitor any changes total number of staff working in HIV service delivery at sites and quality of services.

Numerator

This indicator is neither a numerator nor a denominator.

Method of measurement

To guide quality of data collection, a data collection template has been provided and posted to PEPFAR.net that gathers key data on the inventory or numbers of health care workers at each facility supporting HIV service delivery.

PEPFAR team or Implementing Partners (IP) should collect and report on this data during the last quarter of the year. The data collection template is a component of a rapid site level health workforce assessment tool developed by the PEPFAR HRH TWG, aligned with the first objective of the PEPFAR HRH Strategy. Where possible utilization of the entire rapid site-level health workforce assessment tool is encouraged to get a more comprehensive set of site-level HRH data that goes beyond what is required for HRH_STAFF. Designate one IP per site to collect HRH_STAFF.

If more than one IP is working at the same PEPFAR supported facility, teams should determine which IP will collect data for HRH_STAFF and/or undertake the fuller rapid HRH site-level assessment. Country teams need to collect data from all PEPFAR-supported irrespective of PEPFAR’s financial support of health workers at a particular site (as captured by HRH_CURR.)

Number of health workers reported should be expressed as full-time equivalency (FTE) positions as outlined in data collection template, including part-time health workers or health workers who work part-time on HIV, expressed as fractions of FTE corresponding to estimated hours worked on HIV per week out of total hours per week prescribed as full-time for that cadre in the national scheme of service, or other Ministry of Health guidelines.

Report HRH who are actually actively working on services or programs related to HIV at the time of data collection, not including staff who have resigned, absconded, are dismissed, are pending hiring, or are on extended leave (e.g., for graduate studies). Unfilled positions or vacancies should not be included.

If possible, avoid collecting data across a period which spans across a major budgetary change or a health worker graduation and placement period.

Measurement frequency

From the quick reference guide Annual. Data should be reported in the fourth quarter of the year as a compilation of crosssectional snapshots at each site.

Disaggregation

By cadre group type:

1. Clinical

2.Clinical Support 

3. Management

4. Social Service 

5. Lay

6. Other

Description of Disaggregate

Note: In the indicator narrative, please specify which cadres you included in each cadre group.

1. Clinical workers are those who provide a direct clinical service to clients:(Clinical professionals, including doctors, nurses, midwives, clinical officers, medical and nursing assistants, auxiliary nurses, auxiliary midwives, testing and counseling providers. They should have completed a diploma or certificate program according to a standardized or accredited curriculum and support or substitute for university-trained professionals.) 

2. Clinical Support workers are those who support clinical services at the site but do not directly provide services to clients: (Pharmacists, medical technologists, laboratorians, lab and pharmacy technicians)

3. Management workers are those who provide support to the site for administrative needs but not directly provide services to clients: (Facility administrators, human resource managers, monitoring and evaluation advisors, epidemiologists and other professional staff critical to health service delivery and program support.)

4. Social Service workers are those who have advanced training in social services and provide services directly to clients: Social service workers including social workers, child and youth development workers, social welfare assistants.

5. Lay workers are those who have non-clinical training and provide services directly to clients: (Health workers who provide important services for the continuum of care within facilities and/or communities. These include (but are not limited to) adherence support, mother mentors, cough monitors, expert clients, lay counselors, peer educators, community health workers and other community-based cadres )

6. Other – workers who do not fit into any of the categories above.

Further information

MER 1.0 to 2.0 Change

New indicator

PEPFAR Support definition

A “PEPFAR supported site” for the purpose of this indicator includes any facility site in the PEPFAR master facility list in DATIM which also reported any programmatic target or result during the same reporting period.

Report all HRH at those sites who are working in HIV-related activities, regardless of whether they are supported by PEPFAR or not.

DREAMS SNU Specific Guidance

no additional requirements needed