(PMTCT_STAT) (including PMTCT_STAT_POS) Percentage of pregnant women with known HIV status at antenatal care (includes those who already knew their HIV status prior to ANC)

Export Indicator

Percentage of pregnant women with known HIV status at antenatal care (includes those who already knew their HIV status prior to ANC)
Rationale

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

Numerator

Number of pregnant women with known HIV status at first antenatal care visit (ANC1) (includes those who already knew their HIV status prior to ANC1)

Denominator

Number of new ANC clients in reporting period

Calculation
How to calculate annual total:
 
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

The data source is the ANC register. There is a risk of double counting as a pregnant woman could be tested multiple times during one pregnancy; therefore, partners should ensure a data collection and reporting system is in place to minimize double counting, including a longitudinal ANC register (meaning a register that is able to record all information about one pregnancy in one location, with rows or columns that allow for recording information on multiple visits during that pregnancy). Subsequent testing during pregnancy and breastfeeding will be counted in the new HTS modality: Post ANC1: Pregnancy/L&D/BF. There is also a risk of undercounting if those women who already knew their HIV status prior to attending ANC are not documented, therefore the ANC register should at a minimum should document both “previously known positive” and “newly tested positive”. It may be appropriate to report “known negative” women under the “Recent Negative” disaggregate if national guidelines do not require retesting women known to be HIV negative (often women tested in the last 3 months, however exact timing depends on local guidelines). See disaggregate definitions below for additional information.

Women reported under the “Newly Tested Positive” and “New Negative” disaggs will auto-populate the HTS_TST ANC1 modality. Women who are tested later in pregnancy, during L&D, and/or during breastfeeding should be reported under the HTS_TST Post ANC1: Pregnancy/L&D/BF modality.

Reporting level:

Facility

How to review for data quality:

The % should never be above 100% at a site, and therefore review of the method of data collection and correction of any errors at sites with greater than 100% coverage is important to ensuring data quality for this indicator.

Retesting of HIV-negative women during pregnancy, at L&D and through the postpartum period is an important program strategy is collected under the HTS_TST Post ANC1:

Pregnancy/L&D/BF modality. Please see the HTS_TST reference sheet for more information on collecting this information.

Measurement frequency
Reporting frequency:
 
Quarterly
Disaggregation

Numerator Disaggregations:

Disaggregate Groups:

1. Status and Age [Required]

Underlined portions auto-populate into the PMTCT (ANC1-ONLY) HTS_TST modality.

Disaggregates:

1. • Known Positives: <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+, Unknown Age

• Newly Tested Positives: <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+, Unknown Age

• New Negatives: <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+, Unknown Age

• Recent Negatives at Entry: <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+, Unknown Age
 
 
Denominator Disaggregations:
 
Disaggregate Groups:
 
1. Age [Required]
 
Disaggregates:
 
1. <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50+, Unknown Age
 
 
Disaggregate descriptions & definitions:
 
Status and Age:
 
• Known Positive at entry: Number of pregnant women attending ANC for a new pregnancy who were tested and confirmed HIV-positive at any point prior to the current pregnancy should be reported as known positive at entry. Pregnant women with known HIV status attending ANC for a new pregnancy may not need retesting if they are already on ART, or they may be required to be retested prior to initiating ART based on national guidelines. Known positives who are re-tested and confirmed to be HIV positive prior to initiating ART should still be documented as known positive at entry.
 
• Newly Tested Positive: The number of women attending ANC1 who were tested for HIV and received a positive result. Women who tested negative prior to thispregnancy and are tested again at ANC1 for this new pregnancy should be counted in this indicator.
 
• New Negatives: The number of women attending ANC1 who were tested for HIV and received a negative result. Women who are tested negative prior to this pregnancy and are tested again at ANC1 should be counted in this indicator.
 
• Recent Negative at entry: Number of pregnant women attending ANC for a new pregnancy who recently tested HIV negative and are not eligible – according to country clinical guidelines - for another HIV test at ANC1. For example, women who tested negative within three months of attending ANC1 may not be recommended for testing per country clinical guidelines. This is expected to be a less utilized disaggregate.

 

Explanation of the numerator

The numerator is the sum of the following two data elements:

1. The number of women with a previously known HIV status (both known HIV positive and known negative) attending their first ANC visit (ANC1) for a new pregnancy over the last reporting period.
 
2. The number of women attending ANC1 who were tested for HIV and received results
Explanation of the denominator

N/A

Further information

Indicator changes (MER 2.0 v2.2 to v2.3):

• Age disaggregates updated.
 
• Removal of separate age-only disaggregate to reduce reporting redundancy.
 
• Addition of “Recent Negative at Entry” disaggregate to account for clients at ANC1 who recently tested negative and are currently ineligible for testing (according to national guidelines) at ANC1.
 
• Language added to clarify that subsequent testing events during pregnancy and breastfeeding will now be reported under a new HTS modality: Post ANC1: Pregnancy/L&D/BF (see HTS_TST reference sheet for additional information).

PEPFAR Support definition:

Standard definition of DSD and TA-SDI used.

Provision of key staff or commodities for PMTCT includes: 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.

Guiding narrative questions:

1. Provide context for poor performance in PMTCT_STAT coverage (Numerator/Denominator = STAT coverage) by geographic area, age, or partner/implementing mechanism, including any planned activities/remedial actions.

2. For areas where age disaggregates are NOT completely reported, describe challenges for collecting and/or plan and timeline for collection.
 
Data Visualization & Use Examples:
 
Uptake of ANC Testing and PMTCT Treatment Linkage to EID Cascade:
 
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