(PMTCT_ART) Percentage of HIV-positive pregnant women who received ART to reduce the risk of mother-to-child-transmission (MTCT) during pregnancy

Export Indicator

Percentage of HIV-positive pregnant women who received ART to reduce the risk of mother-to-child-transmission (MTCT) during pregnancy
What it measures

Track progress toward ensuring that all pregnant women who attend PEPFAR supported antenatal care (ANC) know their HIV status and are initiated on ART.

Numerator

Number of HIV-positive pregnant women who received ART to reduce the risk of mother-to-childtransmission during pregnancy

Denominator

PMTCT_STAT_POS (see PMTCT_STAT); 

Denominator is no longer collected as part of indicator, but rather is calculated as PMTCT_STAT_POS

Calculation

How to calculate across reporting periods:

Assuming site level records avoid double counting (as described above) across the annual reporting cycle, sum numerator and denominator across all reporting periods for the annual result

Method of measurement

Data source is the ANC or PMTCT register depending on country context (in many high HIV prevalence settings information on the number of women receiving ART regimens is integrated into the ANC register). There is a risk of double counting as a pregnant woman receiving ART at ANC should have multiple visits for each pregnancy therefore partners should ensure a data collection and reporting system is in place to minimize double counting of the same pregnant women across visits including a paper based longitudinal ANC or PMTCT register (meaning a register that is able to record all information about 1 pregnancy in one location, with rows or columns that allow for recording information on multiple visits during that pregnancy) or an electronic medical record/patient tracking system. There is also a risk of undercounting if those women who already on ART prior to attending ANC are not documented, therefore the ANC register should document both “New on ART” and “Already on ART at the beginning of the current pregnancy”. Women who initiate ART while breastfeeding should not be counted under this indicator, and should instead be reported as part of the TX_NEW indicator (see TX_NEW, disaggregate group pregnancy/breastfeeding status).

Note: Those women reported in PMTCT_ART including newly enrolled on ART and already on ART at the beginning of pregnancy should also be reported in the TX_CURR indicators.

How to review for data quality:

Review any site with over 100% coverage or very low coverage to ensure they reflect expected results. In general, services should be reported at the site where they are delivered (however PMTCT_ART-“already on treatment” and PMTCT_STAT_POS “known positive at entry” are exceptions, see details under description of disaggregate below). Therefore coverage at site level must be understand within the context of the service delivery model at that site. For example, in local areas where ART is integrated into ANC and low volume PMTCT sites are only testing for HIV and then referring women to other facilities for ART, the expectation is that for one individual PMTCT_STAT_POS (newly tested) will be documented at one facility and PMTCT_ART (new on ART) would be documented at another facility leading to the appearance of greater than >100% coverage at one site and 0% coverage at another.

Compare the number of HIV-positive pregnant women newly initiating ART (PMTCT_ART disaggregate) and the number individuals newly initiated on ART (TX_NEW disaggregate) who are pregnant (disaggregation of the new on treatment indicator). It is expected that women are new ART initiations are reported in both indicators, however the data source is often different (ANC/PMTCT register for PMTCT_ART and ART register for TX_NEW) and to discrepancies can provide better understanding of data quality.

Reporting Level

Site level, facility only

Measurement frequency

Report 3 months of results at each reporting cycle

Disaggregation

Numerator (Required):

Number of HIVpositive pregnant women who received ART to reduce risk of motherto-childtransmission during pregnancy

Maternal Regimen Type (Required)

New on ART, Already on ART at the beginning of the current pregnancy (sum of disaggregates = PMTCT_ART_N um)

Description of Disaggregate

For the numerator to be calculated, implementing partners are required to report:

The number of HIV-positive pregnant women newly initiated on ART (These should also be counted in “TX_NEW” see TX_NEW, Disaggregate group breastfeeding/pregnancy status): Should only be counted in a regimen category if she actually received the regimen. Referral alone for ART should not be counted. Additionally a woman who temporarily stopped ART and has started again during the same pregnancy should not be counted as new on treatment.

The number of HIV-positive pregnant women already on ART at beginning of pregnancy: Maybe counted even if ART is continuing to be received at another facility. For example a woman, who is already on treatment, becomes pregnant and enrolls in ANC/PMTCT because she is HIV-positive but is continuing to receive her ART at a nearby treatment clinic should be counted within this disaggregate. However if a woman was initiated on ART at another facility during this pregnancy and then transfers-in to the ANC site, she should not be counted. (since she was already counted at the first ANC site for this pregnancy)

 

Explanation of the numerator

Auto-Calculated indicator in DATIM, sum of: 1) New on life-long ART, 2) Already on life-long ART at the beginning of the current pregnancy

Explanation of the denominator

Collected as part of PMTCT_STAT. Calculated indicator in DATIM, sum of: 1) New Positives, 2) Known Positive at entry (see PMTCT_STAT, Disaggregate Group Positivity Status for more details)

Further information

MER 1.0 to 2.0 Change

Collect only ART disaggregates and collected only at antenatal care (ANC) sites to better align with 2016 Consolidated WHO ARV guidelines, reduce burden on data collection, and improve data quality. Denominator is no longer collected as part of indicator, but rather is calculated as PMTCT_STAT_POS. Reporting frequency is quarterly to align with other PMTCT indicators. Reporting frequency is quarterly to align with other PMTCT indicators.

EA/SIMS considerations

EA: EA has historically excluded PMTCT_ARV (MER1.0) from Adult on Treatment UEs, and calculated a separate PMTCT Women on Treatment UE. To ensure accuracy of the Adult on Treatment UE, any beneficiaries reported in PMTCT_ART (MER2.0) should also be reported in the TX_CURR indicators.

PEPFAR Support definition

Standard definition of DSD and TA-SDI used.

Provision of key staff or commodities for PMTCT include: commodities such as test kits, ARVs, lab commodities, or funding for salaries of health care workers.

Ongoing support for PMTCT service delivery improvement includes: training of PMTCT service providers, clinical mentoring and supportive supervision of PTMCT service sites, infrastructure/renovation of facilities, support for PMTCT service data collection, reporting, data quality, QI/QA of PMTCT services support, ARV consumption forecasting and supply management, support of lab clinical monitoring of patients, supporting patient follow-up/retention, support of mother mentoring programs.

DREAMS SNU Specific Guidance

None