Number of eligible adults and children who newly initiated antiretroviral therapy (ART) during the reporting period (2012)

Export Indicator

Number of eligible adults and children who newly initiated antiretroviral therapy (ART) during the reporting period (2012)
What it measures

Number of eligible adults and children who newly initiated antiretroviral therapy during the reporting period (2011)
Yearly evolution of the number of patients newly enrolled in antiretroviral therapy

Rationale

In addition to coverage it is important to monitor ART initiation. Comparing the evolution of the number of people on ART at the end of the years (indicator G2) does not inform about the number newly initiated, especially since ART attrition is high in the first year and thus the patients newly initiating during the reporting year are not all continuing at the end of the year. Therefore this indicator captures the number of patients newly initiated on ART during a reporting year.

Numerator
Denominator
Calculation
Method of measurement

Facility ART registers and drug supply management forms. By counting the number of patients who are newly enrolled in ART within the reporting period.
Patients with records that transfer in from another facility or who temporarily stopped therapy and have started again in the reporting period should not be counted (risk of double counting).
ARV drugs taken for purpose of PMTCT (except ART for the mother's own health) and post-exposure prophylaxis are not included in this indicator.

Data Quality Control and Notes for the Reporting Tool: Double Reporting: If patients transferred in and out are not correctly registered and if patients followed in different ART sites are not identified, there is a risk for double reporting which could lead to an overestimation of ART initiation. If this is the case, please comment.
Similarly if patients temporarily stopping ART and restarting are coded as new patients, this will overestimate the true number of patients newly initiated.
National Representativeness: the numerator is a national cumulative indicator, usually produced by all health facilities, otherwise it may estimate ART initiation. Please comment on your data as necessary.
Triangulation Options: Pharmacy report, comparing the number of new patients in the pharmacy register and the ART register

Measurement frequency
Disaggregation

Age group: (greater than) 14 years

Gender: Male, Female

Sector: Private, Public

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator permits monitoring trends in initiation but does not attempt to distinguish between different forms of antiretroviral therapy or to measure the cost, quality or effectiveness of treatment provided. These will each vary within and between countries and are liable to change over time.
The degree of initiation of ART will depend on factors such as cost relative to local incomes, service delivery infrastructure and quality, availability and uptake of voluntary counselling and testing services, and perceptions of effectiveness and possible side effects of treatment.

Additional considerations:
This indicator should be analysed in view of the 'waiting list' i.e. patients eligible for ART and not initiated.

Data utilization: In addition to the number of old patients retained on ART (retention on ART) the number of patients newly initiated is necessary for accurate planning of resources and drug stocks (avoiding shortage and wastage)

Further information

Other references: PEPFAR indicator and guidelines