Number of HIV-positive adults and children receiving a minimum of one clinical service

Export Indicator

Number of HIV-positive adults and children receiving a minimum of one clinical service
What it measures

This indicator attempts to measure how many HIV-positive individuals received care and support services, defined by receipt of at least one clinical service. Data collected through this indicator will inform country programs and PEPFAR about scale up of care services for HIV-positive individuals. With these data, HQ can provide additional support and technical assistance to countries in strengthening network systems that assure access and use of care services by HIV-positive individuals.

Rationale

People living with HIV/AIDS (PLWHA) should receive a comprehensive package of services in order to improve quality of life, extend life and delay the need for ART. The goal should be to provide services in each of 5 domains described in PEPFAR care and support guidance (clinical, psychological, spiritual, social, and prevention) and to provide these services using a holistic approach, from the time of HIV diagnosis. While the goal of programs should be to ensure a comprehensive package of care and support services, clinical services are essential for all HIV-positive individuals.

All HIV-positive individuals should receive clinical services, including for example assessment for symptoms of tuberculosis or need for OI prophylaxis or ART. To be counted for this indicator, HIV-positive individuals must receive a minimum of one clinical service. This indicator attempts to track progress in providing care and support services to all HIV-positive individuals. Please refer to Appendix 2 for a list of services.

Numerator

Number of HIV-positive individuals receiving a minimum of one clinical service

Denominator

Not applicable

Calculation

Not applicable

Method of measurement

The numerator can be generated by counting the number of HIV positive adults and children who received at least one clinical service.

The numerator should equal the number of adults and children with HIV infection who have received one care service and specifically are receiving at least one clinical service during the reporting period.

Individuals may receive care and support services from different partners. For example, a patient may receive a clinical service from partner A and social services from partner B. In this case the patient will be counted under indicator C1.1.D as well as this indicator (#C2.1.D). However, if an HIV-positive patient receives a care service that does not include a clinical service, he/she may be counted under indicator C1.1.D only and may not be counted be counted under this indicator.

The aggregated total for this indicator is not simply the sum of the individuals served by all partners. Overlap of services provided by facility-based care and support and community/home-based care and support partners must be adjusted for so that individuals are counted only once in the aggregated total.
Clinical services may be provided in facilities, the community, or in the home, and may include both assessment of the need for interventions (for example assessing pain, clinical staging, eligibility for Cotrimoxizole, or screening for tuberculosis) and provision of needed interventions: prevention and treatment of TB/HIV, prevention and treatment of other opportunistic infections (OIs), alleviation of HIV-related symptoms and pain, nutritional rehabilitation for malnourished PLWHA.

While partners may be supported to provide services only in a single domain (for example only social support), individuals receiving that support should be linked to other providers who provide clinical services to meet the criteria to count an individual as receiving one clinical service. Please refer to appendix 2 for a list of clinical services.

While a minimum of one clinical service is sufficient to count an HIV-positive individual for this indicator, PEPFAR requires that programs strive to provide comprehensive care to all HIV-positive individuals by providing other needed services (clinical and support services) either directly or through referral.

Individuals who receive services from more than one partner or provider should be de-duplicated at the program summary level.

Disaggregation:
Essential/reported Males
Essential/reported Females
Essential/reported Essential/reported 15+ years of age
Recommended Age represents an individual’s age at the end of the reporting period or when last provided with a clinical care service.

Measurement frequency

Continuously

Disaggregation

Age group: (greater than) 15 years

Condom type: N/A

Education: N/A

Gender: Male, Female

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

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 the total number of unduplicated HIV-positive individuals receiving a minimum of one clinical service from facilities and/or community/home-based organizations. While an individual must receive at least one clinical care service to be counted, this indicator does not articulate what type of clinical service was provided, or where it was provided, nor does it capture other care and support services (from the other domains of care (i.e. support services) that may have been provided. Data from this indicator will not assess linkages within or between care and support sites.

This indicator allows country programs and PEPFAR Headquarters to monitor trends and coverage of at least one clinical service to HIV-positive persons. The specific clinical or other care and support services an individual may require will vary according to several factors including stage of disease, treatment, service availability, and cost. This indicator does not measure quality or effectiveness of services.

Further information