VCT centres with minimum conditions to provide quality services

Export Indicator

The percent of clients served by VCT services that meet minimum conditions necessary to provide quality counselling and HIV testing services
What it measures

In many countries voluntary counselling and testing has landed in the hands of under-funded and ill-equipped non-government and community organisations, or has become a corollary of private sector health service providers. Many of these lack even the most basic structural facilities necessary to provide quality counselling, such as a room where counsellingcan be undertaken privately, or a regular electricity supply to ensure the adequate storage of specimens until testing. This indicator measures the proportion of providers of counselling and testing that have the basic structural requirements to provide quality counselling. Since sites are weighted by client volume, the indicator is given as the percentage of clients served by sites with adequate conditions.

Rationale
Numerator

Number of clients served in the last year by sites with adequate conditions to provide quality VCT services

Denominator

Total number of clients served in the last year by all sites sampled

Calculation
Method of measurement

A random sample of providers of counselling and testing services (including NGOs, private clinics and doctorsÂ’ surgeries) are checked for the structural elements necessary to provide quality counselling and testing services. These include trained staff, adequate privacy for counselling, systems for maintaining confidentiality, a directory of services for referral, and adequate conditions for ensuring quality control of specimen tests. The score obtained by each site in the random sample is weighted by the annual client load of that site. The indicator is the number of clients served in the last year by sites with adequate conditions to provide quality VCT services, divided by the total number of clients served in the last year by all sites sampled.

Measurement frequency
Disaggregation

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: Private, Public

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 measure of something that is necessary but not sufficient to guarantee quality counselling services. The percentage of clients served in a facility that meets conditions for quality counselling is also likely to reflect other factors, such as access, available testing services, or a history of positive experiences at the centre by other community members. Inevitably, a number of contextual variables are reflected in an indicator assessing quality. The goal of the indicator is to provide a framework for assessing some accepted goals and guidelines. A potential difficulty in constructing this indicator is that sites with inadequate record keeping may be unaware of their overall client load, and it will therefore not be possible to weight the indicator by client load. It is possible to construct the indicator as a simple percentage, i.e., the percentage of facilities surveyed which meet minimum conditions for adequate service. However because poor conditions at a small facility with a low caseload is relatively less important than poor facilities at a large and busy centre, weighting should be applied where possible. (In truth, there may be a strong correlation between conditions and caseload: caseloads may be low because conditions are poor.) As with other aggregate indicators, information on different elements may need to be provided separately for programme planning purposes. It may also be useful to disaggregate this indicator by type of service provider (NGO, hospital, private clinic, etc.).

Further information