Percentage of designated facilities providing ART in-line with national standards

Export Indicator

The percentage of designated health care facilities at different levels of the health care system that have the capacity to provide ART in-line with national standards.
What it measures

In the recent years, tertiary level institutions have started providing ART in line with national standards. The program components should reflect country needs, but generally include: trained staff, uninterrupted drug supply, regular reporting in-line with national standards, ability to monitor patients, use of standard regimes (although in the public sector this may always be the case), and regular supervision. Many countries have produced national guidelines to help guide service providers in the appropriate provision of ART in-line with national standards. These standards cut across at least 5 components (above), with an optional one more difficult to measure (supervision). With the scaling-up of efforts, attempts are being made to ensure that HIVrelated conditions are dealt with at appropriate levels within the health system, with referrals in both directions when necessary. This indicator measures the extent to which health services have the capacity to meet treatment with the provision of ART of HIV-infected patients at appropriate levels of the health care system, according to national guidelines.

Rationale
Numerator

 

Denominator

 

Calculation
Method of measurement

This indicator can be measured as proposed in the soon to be released National AIDS Programmes: A Guide to Monitoring and Evaluating HIV/AIDS Care and Support . Core indicator 7.Percent of health facilities that have the capacity and conditions to provide advanced level HIV care and support services, including provision and monitoring of ART
a. Systems and items to support management of opportunistic infections and provision of palliative care (symptomatic treatment) for advanced care of clients with HIV/AIDS;
b. Systems and items to support advanced services for HIV/AIDS care;
c. Systems and items to support ART services;
d. Conditions to provide advanced inpatient care for clients with HIV/AIDS;
e. Conditions to support home care services; and
f. Post-exposure prophylaxis.
A health facility survey is required to measure the extent to which ART is being administered and monitored in line with existing standards.

Measurement frequency
Disaggregation

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator is a compendium of many different aspects of care and service provision, all of which must score a minimum amount if the facility is to be included in the numerator of the indicator. Because services tend to improve unevenly, especially in resource constrained settings, the resulting indicator may remain low for some time. Disaggregation of the indicator will indicate the areas in which services have improved and those in which they continue to lag. The scoring of the components of the indicator will necessarily include a measure of subjectivity. This may influence comparisons between different countries, as well as trends over time if the monitoring team changes.

Further information