Percentage of health facilities with systems and items for provision of antiretroviral therapy services

Export Indicator

Percentage of health care facilities at different levels of the health care system which have systems and items for the provision of ART services. This indicator is the same as Indicator 7, subcomponent (c) in the Care and Support Guide: Capacity to provi
What it measures

 
This indicator measures the availability and quality of ART services. It is assumed that, in most cases, these services are offered in health care settings that can provide advanced health care. The indicator can be measured as one component of Core Indicator 7 in the Care and Support Guide, which includes other aspects of advanced clinical and psychosocial services complementary to the provision of ART (e.g. management of opportunistic infections, advanced inpatient care for people living with HIV/AIDS).

Rationale
Numerator

Number of health facilities providing ART which have all the systems and items necessary for providing ART services of satisfactory quality (as described in How to measure it).

Denominator

Total number of ART-providing health facilities surveyed.

Calculation
Method of measurement

 

The information should be collected through a health facility survey on the basis of observations made in all relevant service areas.
For inclusion in the numerator a facility must meet the following criteria.
(a) Observed guidelines or protocols for:
(1) treating and preventing opportunistic infections; (2) providing palliative care (controlling symptoms and pain); (3) caring for children and young people living with HIV/AIDS; (4) standard operating procedures for services and interventions for people living with HIV/AIDS; (5) observed treatment guidelines for the management of ARV therapy for adolescents, adults pre-adolescent children.
(b) Country-specific ARV drugs regularly available with no reported stock-outs in the preceding six months. Stock cards should be inspected and any stock-outs in the preceding six months should be noted.
(c) Facilities with laboratory capacity to conduct a documented system for referral and the receipt of results for at least one of the following tests: (1) CD4 count or CD4 alternative, total lymphocyte count test or viral load test;
 
or Facilities with capacity to conduct a documented system for referral and receipt of laboratory tests, including: (2) a record or register that includes the referral and test result and (3) an indication that the test result or follow-up was given to the person tested.
(d) A system of appointments and follow-up which indicates appointment schedules and shows whether clients have kept appointments.
(e) Individual client cards identifying the number of clients receiving ART at the facility in question.

(f) At least one ARV therapy service provider in the facility trained during the preceding 12 months in the provision of ART, counselling on drug adherence, risk-reduction counselling, nutritional rehabilitation and nutritional problems associated with ARV.
(g) At least half the interviewed providers of ART services should have been personally supervised during the preceding three months.

Measurement frequency

Every 2-4 years

Disaggregation

Age group:

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 should be present if the facility concerned is to be included in the numerator. Because services tend to improve unevenly, especially in resource-constrained settings, the resulting indicator may remain low for some time. Disaggregation of the indicator reveals the areas where services have improved and the areas where they continue to lag. The scoring of the components of the indicator necessarily includes some subjectivity. This may influence comparisons between countries, and, if the monitoring team changes, trends over time.

Further information