Number of health facilities that offer paediatric antiretroviral therapy (ART)

Export Indicator

Number of health facilities that offer paediatric antiretroviral therapy (ART)
What it measures

Antiretroviral therapy is a cornerstone of effective HIV treatment, and measuring the percentage of health facilities that offer paediatric ART provides valuable information about capacity to address HIV care in children.

Rationale

Number of health facilities that offer paediatric ART.
Capacity of health facilities to provide paediatric antiretroviral therapy (ART),expressed as percentage of health facilities that offer paediatric ART. Health facilities include public and private facilities, health centres and clinics (including TB centres), as well as health facilities that are run by faith-based or nongovernmental
organizations.

Numerator
Denominator
Calculation
Method of measurement

The numerator is calculated by summing of the number of facilities reporting availability of paediatric ART services. Information on the availability of specific services is usually kept at the national or sub-national level. National AIDS
Programmes should have a record of all health facilities offering ART services.
A health facility census or survey can also provide this information, along with more in-depth information on available services, provided the information is collected from a representative sample of health facilities in the country.
Responses to a series of questions establish whether providers in that facility provide paediatric ART services directly or refer patients to other health facilities for these services. In addition, facility records documenting the current status of service provision should be consulted. One potential limitation to facility surveys or censuses is that they are usually only conducted once every few years.
Countries should regularly update their programme records on health facilities offering paediatric ART services, and supplement these data with those obtained through a health facility survey or census every few years. For health facility surveys or censuses, tools such as the Service Provision Assessment (SPA) or the Service Availability Mapping (SAM) can be used.
A denominator is not requested in the UA reporting tool but some countries trying to expand paediatric ART nationally can consider Total number of health facilities, excluding specialized facilities where paediatric ART services
are/will never be relevant, which can be calculated by summing the total number of health facilities included in the sample. Information for construction of the denominator may come from programme records, facility listings, and/or national strategy or planning documents. It should exclude specialized facilities where paediatric ART services are/will never be relevant. (e.g. facilities specializing in eye care where ART will never be introduced)

Data Quality Control and Notes for the Reporting Tool:
Please comment on whether the data reported is from a national facility listing or census, or from a survey. If a survey, please remember to report the year of the survey. If data from the private or other sectors is missing, please comment.
If it is possible to easily report any additional information on the geographical distribution of facilities offering paediatric ART (e.g. urban/rural, %facilities with ART in areas with a high concentration of PLWA), please provide extra details.

Measurement frequency
Disaggregation

Sector: Private, Public

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator provides valuable information about the availability of paediatric ART services in health facilities, but it does not capture information about the quality of services provided. Antiretroviral therapy itself is complex, and it should be delivered as part of a package of care interventions, including the provision of cotrimoxazole prophylaxis, the management of opportunistic infections and comorbidities, nutritional support and palliative care. Simple monitoring of ART availability does not ensure that all ART-related services are adequately provided to those who need them.
Nevertheless, it is important to know what percentage of health facilities provide ART services in order to plan for service expansion as needed to meet universal access targets.
One potential limitation to facility surveys or censuses is that they are usually only conducted once every few years and may not capture the latest information especially in setting with recent intensified scale-up.

Additional considerations:
• One strategy to scale up ART services is to make ART including paediatric ART services available in more health facilities. This may be achieved by decentralizing ART services from tertiary facilities (e.g. hospitals) to primary or
secondary-level health facilities. Greater availability of paediatric ART services provides crucial support to the goal of universal access to HIV treatment.
Depending on the country's epidemic type, the denominator may not be as relevant if the HIV program strategy aims to target a limited number of sites to offer paediatric ART in.

Data utilization: Look at trends overtime. Explore the number of facilities that provide ART in relation the estimated number of children in need of ART.

Further information