Women completing the testing and counselling process
The indicator provides a broad measure of programme coverage in the country concerned. However, issues of poor access to services and poor uptake result in only a small percentage of women knowing their status. It is therefore important to refer to the programme-level indicator described in the footnote below.
An additional important programme-level counselling and testing indicator must be considered when a PMTCT programme is being managed. The indicator measures the points in the provision of counselling and testing for pregnant women at which women drop out. This information can be used to investigate further why women drop out at specific points, and, ultimately, to reduce the percentage of drop-outs. Such information is therefore important for programme planning. The indicator includes the following three components. a) The number of pregnant women who have made at least one ANC visit and have been counselled at a PMTCT site, divided by the total number of pregnant women. b) The number of pregnant women who have accepted testing for HIV, divided by the total number of pregnant women who have made at least one ANC visit and have been counselled at a PMTCT site. c) The number of women receiving post-test counselling and HIV results, divided by the total number of pregnant women who have made at least one ANC visit and have been counselled at a PMTCT site.
The number of pregnant women who have received an HIV test result and post-test counselling in the preceding 12 months.
The estimated number of pregnant women giving birth in the preceding 12 months who have made at least one ANC visit.
The indicator requires that programme records be reviewed in order to count how many women have completed the testing and counselling process, i.e. have received their test results and post-test counselling. The number of women who have made at least one ANC visit is estimated by multiplying the number of births in the preceding 12 months, as given in a census or the best available source, by the rate of ANC attendance (Demographic and Health Surveys-type sample survey). In some cases the numerator may be obtainable by examining national records. If this is not possible the required data are likely to be available at the district level, where they can be collected directly from facilities providing the services in question. In some cases the denominator may be obtainable by examining national ANC registries. This is the preferable denominator and should be used if possible. If this number is not available or reliable the estimate of the number of pregnant women described above can be substituted but this approach involves an increased possibility of misinterpretation. The indicator should be measured annually.
Geographic location: N/A
Pregnancy status: N/A
Time period: N/A
Type of orphan: N/A
Vulnerability status: N/A
As stated in National AIDS programmes: A guide to monitoring and evaluation, this indicator provides a broad measure of service provision and gives an idea of coverage in ANC settings where PMTCT interventions are available. It does not attempt to inform service providers about the points in the counselling and testing cycle at which women drop out. It is important that programme managers employ a series of lower-level indicators for determining losses to follow-up. Because the quality of services is not being measured, information on drop-outs and the points at which they occur is of limited use if not followed up with operations research aimed at discovering why women are failing to complete the cycle.