Percentage of health facilities that provide virological testing services (e.g. PCR) for diagnosis of HIV in infants on site or from dried blood spots (DBS)
Method of measurement:
The numerator could be calculated by one of three methods, depending on the availability of information at central institutions:
(a) national programme records of lists of facilities that perform virological testing on-site or through dried blood spots;
(b) lists of distribution of dried blood spot kits by site, in central medical stores, private or nongovernmental organization-run medical stores responsible for national distribution or national reference laboratory; and
(c) facility survey or questionnaire about whether the site is providing virological testing on site or through dried blood spots.
In many countries, virological testing is performed only at a national reference laboratory or sent out of the country due to the cost of buying virological testing machines. Thus, the ‘provision’ of virological testing includes on-site testing as well as transport of dried blood spot filter papers to a virological testing laboratory.
Sites that refer a mother and her infant to a site that provides virological testing on site or through dried blood spots are not included in the numerator.
The denominator comprises all health facilities at any level that provide follow-up for HIV-exposed infants, including maternal and child health clinics, sites where a unit for PMTCT is responsible for the follow-up of HIV-exposed infants, nutritional centres, district hospitals and care and treatment sites.
All public, private and nongovernmental organization-run health facilities that provide follow-up for HIV-exposed infants should be included.
Disaggregation By availability of virological tests: On site; through DBS
Uncategorized/Other category exists if you know virological tests are provided, but you are unsure whether it is done onsite or through DBS.
Data Quality Control and Notes for the Reporting Tool:
- Double Reporting: If compiling data from multiple sources, ensure no facility is counted twice.
- National Representativeness: Try to ensure information from non-governmental and private facilities are also available at the central level. If significant information is missing, note it down.
- See Denominator explanation above - The total # of health facilities is used as a proxy, but if you have more accurate data on the denominator of this indicator (i.e. number of facilities where infant follow-up is possible), please report this number (or an estimate) in the Comment section.
Programme / Service Delivery
Strengths and weaknesses:
This indicator does not measure the quality of the virological testing at sites, nor the quality of the system in place, including length of turnaround time, stock-outs of DBS or virological testing reagents, and other bottlenecks in the system.
Additional considerations for countries:
In addition to monitoring the expansion of virological testing capacity at health facilities, countries may wish to periodically monitor bottlenecks in the system to expand testing capacity, including national, district level or facility level stock outs of testing materials; turnaround times for test results; human resource availability and trainings conducted; and tools available to appropriately track samples and receipt of results.
Data utilization: Look at trends overtime. Review where services are available and identify any gaps. Explore further data available on the average time it takes for test results.
World Health Organisation (WHO)
Goal - Initiative or Country: