File for describing indicators
| Name of indicator | Include the name of the indicator. |
| Definition of indicator | Describe how the indicator is formulated, including key parameters. |
| Purpose of indicator | Indicate why it is important to use the proposed indicator and/or its parameters. |
| Interpretation | Describe the context, when necessary, the indicator's significance, and what it measures. |
| Uses | Describe the indicator's main uses for public health purposes. |
| Calculation method | Describe how the indicator is calculated, including the numerator, the denominator, and the corresponding formula, when relevant. |
| Type of indicator | Indicate whether the measurement of the indicator is an absolute number, a proportion, a rate, etc. |
| Unit of measurement | Specify the units of measurement used for the indicator. |
| Frequency of measurement | Indicate how often data for the indicator are compiled and reported. |
| Area of reference | Indicate the country or geographic area to which the indicator refers. |
| Reference period | Specify the time period, or point in time, to which the indicator refers. |
| Disaggregation | Describe the levels of disaggregation that are practically available, in terms of their possible contribution to the interpretation of the data. Analytical categories: sex, age group, ethnic origin, and geographic area (state, province, urban/rural). |
| Data source | Identify the source of the indicator's data. Specify main data source, where applicable. |
| Limitations | Specify the challenges or constraints in the indicator's measurement, use, and interpretation. |
| Institution responsible | Include the name of the entity or unit responsible for generating, reporting, and monitoring the indicator. |
| Technical notes | Include all relevant matters related to the construction of the indicator that could hinder its use and interpretation. |
Adapted from the Technical Files used for the PAHO Core Health Data and Country Profiles. Health Information and Analysis Unit (PAHO/ CHA /HA), PAHO Strategic Plan 2014-2019 and RIPSA.
MODEL FILE
| Code and name of indicator | RIT 1.1.1. "ANTIRETROVIRAL THERAPY COVERAGE (ART)" |
| Name of indicator | Number of countries and territories that have 80% antiretroviral therapy (ART) coverage in the eligible populations. |
| Definition of indicator | This indicator measures the coverage of access to antiretroviral therapy. Coverage of 80% or more among people who meet criteria for treatment is defined internationally as universal access. Until mid-2013, the criteria for eligibility were people living with HIV who had a CD4 count of 350/ml or less. On the basis of the new WHO guidelines published in June 2013, the threshold recommended for initiating antiretroviral therapy has been raised to a CD4 count of 500/ml or less, which means that the number of eligible people (the denominator) will increase. Baseline 2013: 6 countries Target for 2019: 22 countries |
| Purpose of the indicator | The proposed indicator is designed to monitor access to antiretroviral therapy, a key element in ongoing prevention, treatment, and care that has a strong impact on public health outcomes, including the reduction of HIV-related morbidity and mortality and the prevention of transmission. |
| Unit of measurement | Calculation at the national level: For calculation at the country level, the numerator is the number of people who receive antiretroviral therapy and derives from reports submitted by ministries of health. The denominator is an estimate of the number of people who need antiretroviral therapy. The country denominators are generated using methodologies and standardized statistical modeling instruments and are provided by UNAIDS. Calculation at the regional level: Having calculated the percentage of coverage at the national level, the regional indicator is obtained by counting the number of countries and territories with coverage of 80% or more. Multiple data sources are used, since not all countries are included in the various reports. At the national level, data collection is continuous, with calculation of country coverages conducted at year end. |
| Type of indicator | Absolute |
| Unit of measurement | Number of countries and territories. |
| Frequency of measurement | Annual, at year end. |
| Unit of the PASB responsible for monitoring the indicator | HIV, hepatitis, tuberculosis, and sexually transmitted infections (CHA/HT). |
| Data source | UNAIDS, WHO, country reports on universal access, and reports on progress in the global response to AIDS. |
| Limitations | There are uncertainties with respect to the accuracy of the statistical modeling in the case of smaller countries with concentrated epidemics. It is difficult to make a reliable calculation of denominators for very small populations. Moreover, for some countries, including the small island states, UNAIDS does not generate denominators. The recommended change in the eligibility criteria from a CD4 threshold of 350/ml to one of 500/ml will increase the estimated number of eligible people (denominator), leading to an apparent reduction in coverage. The impact of this change on the monitoring of the indicator should be taken into account. This indicator measures total antiretroviral therapy coverage, but does not measure inequalities in coverage, in particular as this affects key populations such as MSM, sex workers, and transgender people. Local problems, such as undocumented immigration, will also influence the indicator's accuracy. Continuous monitoring of these key population groups' access to treatment, as well as care quality, is essential. |
| References | HIV Continuum of Care Monitoring Framework. Addendum to meeting report: Regional consultation on HIV epedimiologic information in Latin America and the Caribbean. Pan American Health Organization, 2014. |