Number of health workers trained on ART delivery in accordance with national or international standards

Export Indicator

Number of health workers (by type) newly trained or retrained on ART delivery in accordance with national or international guidelines during the preceding 12 months. This covers health workers who have been trained to a level enabling them to take up a di
What it measures

This indicator measures the availability of a trained workforce for achieving national scale-up targets. It includes both clinical and non-clinical health workers who contribute to the development and implementation of ART services and provide critical support services.

Rationale
Numerator

Number of newly trained or retrained health care workers in the selected health facilities providing ART.

Denominator

Total number of health care workers in selected facilities providing ART.

Calculation

If data are obtained from facility-based surveys (records of training kept in facilities):
a) The indicator can be calculated as a percentage for the sampled health facilities:
• Numerator: Number of newly trained or retrained health care workers in the selected health
facilities providing ART.
• Denominator: Total number of health care workers in selected facilities providing ART.

Method of measurement

WHO (ARV): The information for this indicator can be obtained from either of two sources:
1) Programme records of organizations (private or public organizations, or NGOs) that are providing the majority of ART-related training in a given country. In most countries a limited number of such organizations is responsible for all training (usually known to the national AIDS coordination body), and the information for this indicator can be collected from their records.
2)Facility-based surveys (of facilities providing ART).
If data are obtained from programme records: a) The source (name, type of organization, date and persons contacted) should be noted when the information is collected. b) The indicator gives information on the overall size of the health workforce trained on HIV/AIDS in the country concerned. c) The indicator does not, however, assess whether trained health workers are working in facilities providing ART. This link is crucial for monitoring progress in the scaling up of ART services: Core Indicator 5, section (f) in the present document allows for this link to be made; it assesses whether a facility has at least one staff member providing ART who has been trained in the preceding 12 months. d) In combination with information on facilities this indicator can help to identify bottlenecks in human resource management. For example, reports on personnel shortages in facilities can be compared with information on the nationally trained workforce and judgements can be made as to whether such shortages are absolute or relative, e.g. if associated with hindrances to recruitment such as geographical barriers and/or a lack of incentives.

If data are obtained from facility-based surveys (records of training kept in facilities):
a) The indicator can be calculated as a percentage for the sampled health facilities: • Numerator: Number of newly trained or retrained health care workers in the selected health facilities providing ART. • Denominator: Total number of health care workers in selected facilities providing ART. b) The indicator shows whether the trained individuals are also working in ART-providing facilities (and it links directly with Core Indicator 5, section (f) in the present document, which assesses whether health facilities each have at least one staff member providing ART who has been trained in the preceding 12 months). Regardless of the source of information, data must be collected separately for each group of health workers listed above, although it can be aggregated into one group for ease of reporting. However, the information is most insightful when reported by type of personnel. The minimum acceptable quality of training should be defined before the information is col

Measurement frequency

Annual

Disaggregation

Condom type: N/A

Education: N/A

Gender: N/A

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: Private, Public

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Type/Timing of testing: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator is most useful in the initial phases of a countrywide response to HIV/AIDS, when the cumulative number of trained health professionals is expected to be continuously increasing until it reaches a critical mass (or desired ceiling). At this point the quantitative focus of the indicator on the number of health workers trained may become redundant, and measurement may shift so as to capture the quality of training, refresher training and the testing/supervision of health care practices as outlined below.
• Assessment of training programme: its content and duration; its compliance with international standards and issues of local relevance.
• Assessment of results of training, involving measurement of health providers' knowledge and attitudes, self-assessment and direct observation of their practice.
• Measurement of continuous and improving competence over time (e.g. recertification, continuous education, knowledge and performance assessments, practice audits).
• Implementation of certification schemes that attest to the competence of individuals to practice.
WHO is working with partners on the development of guidelines and tools for the development and implementation of certification programmes. Additionally, some countries may be able to evaluate the performance of health workers through operations research.

Further information