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Guide for Monitoring and Evaluating National HIV Testing và Counselling (HTC) Programmes: Field-Test Version. Geneva: World Health Organization; 2011.
Guide for Monitoring và Evaluating National HIV Testing and Counselling (HTC) Programmes: Field-Test Version.
Show detailsAppendix 3HIV testing và counselling (HTC) indicators in population-based surveys1(22) and health facility-based surveys
HTC service data should be collected routinely, & collated và aggregated regularly at the national màn chơi through a strong health management information system. Another method for collecting data to help monitor và evaluate điện thoại htc programmes includes population-based surveys. Data from such surveys can be reviewed together with data collected from programme service statistics to get a better picture of testing và counselling programmes in a country. Data from population-based surveys also have other benefits as they remove any double-counting of people tested, which is more difficult to lớn implement with service statistics.
Why population-based surveys?
Population-based surveys are recommended for collecting utilization/coverage statistics for điện thoại htc programmes. In particular, these are needed khổng lồ understand the percentage of a specified population that has been tested in the past 12 months & received the results.
Routine monitoring data on coverage from service statistics can be difficult lớn interpret when testing may be provided anonymously & if people go for multiple tests in a year or when the denominator or size of the specified population is difficult to lớn determine, as is the case for some MARPs. These issues are not a problem in population-based surveys, assuming that the method of sampling used allows a representative sample of the specified population to lớn be drawn. However, this assumption must be assessed carefully, particularly for MARP or other specified groups, for whom representative sampling is particularly challenging.
The Demographic và Health Surveys (DHS) & the AIDS Indicator Surveys (AIS) are common standardized surveys implemented in many countries; they also include information on htc collected among the general population. MEASURE DHS, funded by the United States Agency for International Development (USAID), supports data collection và analysis activities related khổng lồ these surveys.
DHS: These are nationally representative household surveys that provide data for a wide range of monitoring & impact evaluation indicators in the areas of population, health và nutrition. They have large sample sizes (usually between 5000 và 30 000 households) & are typically conducted every five years to lớn allow comparisons over time. Preparation khổng lồ conduct a DHS usually takes six to lớn 12 months, depending mainly on funding và contractual issues, but also on the inclusion of biomarkers and considerations such as the optimum timing of data collection vis à vis weather, elections or exigent circumstances. Data collection usually takes two khổng lồ five months, while data processing, report preparation, review, formatting and printing usually require six khổng lồ 12 months from the kết thúc of data collection.
AIS: These surveys were developed to provide countries with a standardized tool to obtain indicators for effective monitoring of national sida programmes. The kiến thiết for the AIS was guided by the need to have a survey protocol that would provide, in a timely fashion & at a reasonable cost, the information required for meeting sida programme reporting requirements while ensuring comparability of findings across countries & over time.
In addition to general population surveys, HTC-related questions can be added lớn behavioural surveillance surveys (BSS) or integrated biological and behavioural surveys (IBBS) conducted among MARP or other high-risk groups.
MICS: UNICEF assists countries in collecting & analyzing data to fill data gaps for monitoring the situation of children và women through its international household survey initiative, the Multiple Indicator Cluster Surveys (MICS). Since the mid-1990s, the MICS has enabled many countries khổng lồ produce statistically sound and internationally comparable estimates of a range of indicators in the areas of health, education, child protection và HIV/AIDS. MICS findings have been used extensively as a basis for policy decisions & programme interventions, and for the purpose of influencing public opinion on the situation of children and women around the world. UNICEF is currently supporting the fourth round of MICS. More about MICS can be found at http://www.childinfo.org/mics.htm
Appropriate methods of sampling
Population-based surveys that are appropriate for these types of coverage statistics for smartphone htc programmes are those that utilize probability sampling techniques. For the general population, this would include multistage cluster sampling through household surveys, or random digit dial surveys (where most of the general population is accessible by phone). For MARPs, particularly those that are mobile and/or hidden, appropriate sampling methodologies include time–location cluster sampling (TLS) or respondent-driven sampling (RDS). (23)
Facility-based samples are not considered khổng lồ be population based and may need khổng lồ be interpreted with caution, particularly for measures of coverage among specific subpopulations, because they are selective of only those people who access services & do not provide a larger picture of testing behaviour representative of the whole population. Convenience sampling may be the only feasible method of sampling in some settings. However, the interpretation of convenience-based samples is problematic because the population represented by such samples is biased in an unknown way & cannot be generalized lớn a wider population.
Coordination with existing surveys
Because the amount of information required for M&E of smartphone htc programmes from population-based surveys is relatively small, it does not make sense to lớn launch population-based surveys for the sole purpose of collecting htc M&E data. The small number of questions related lớn the điện thoại htc programme should be added lớn existing, planned surveys that are conducted for broader use. This will require the htc programme lớn coordinate closely with other groups responsible for organizing population-based surveys & have a ready, short các mục of prioritized smartphone htc questions that can easily be inserted into a questionnaire.
Testing và counselling indicators in standardized population-based surveys (DHs/AIS)
The following indicators are included in the generic questionnaires used as the base for the DHS and AIS in most countries:
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i. Respondents are asked whether they know a place where they can get an HIV test.
»ii. Those who know an HIV testing site form the numerator, while the denominator is all respondents in the survey.
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i. Respondents are asked whether they ever requested an HIV test, whether they were tested and, if so, whether they received the results.
»ii. Those who requested a test & received the results khung the numerator, while the denominator is all respondents in the survey.
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i. Respondents are asked whether they were tested in the past 12 months and, if so, whether they received the results.
»ii. Those who were tested và received results in the past 12 months size the numerator, while the denominator is all respondents.
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i. Young (age 15–24 years), sexually active respondents are first asked if they have ever been tested for HIV. Those replying in the affirmative are asked whether they were tested in the preceding 12 months and, if so, whether they know the results of their test.
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i. Female respondents who have given birth in the two years before the survey are asked if they received HIV counselling during ANC, whether they accepted an offer of HIV testing, and whether or not they received the results.
In DHS/AIS that also include blood testing for HIV prevalence, analysis can also include HIV prevalence by prior HIV testing, i.e. Whether or not HIV-positive respondents have been tested previously và whether they know their results. This serves as a proxy for knowledge of current status, although it is possible that respondents have become infected since their last HIV test.
Other types of issues to lớn include in population-based surveys
If a population-based survey is planned, & the smartphone htc programme has an opportunity to địa chỉ cửa hàng several questions in addition to the basic coverage question of whether respondents have been tested in the past 12 months và received their thử nghiệm results, the following examples of issues should be considered:
Place of last chạy thử – this can help determine the role of private laboratory testing in different populations.
Reason for last test – this can help determine whether mandatory testing is a problem, and whether people are testing based on self-perception of risk, or by referral.
Client perceptions that testing is voluntary & confidential – these data will corroborate other information about the quality of services provided, particularly if it can be traced back to lớn a type of service or specific place of service.
Satisfaction with last htc experience – these data can help corroborate whether services provided are satisfactory khổng lồ clients. This can be particularly helpful when traced back lớn the type of service or specific place of the last test.
Knows where to go for smartphone htc – this can help determine whether access is being promoted well, & priority populations know that services exist. This aspect can be key lớn interpreting data on accessibility of service.
Interpreting population-based survey data
When using population-based survey data to lớn assess the performance of htc programmes, a number of key issues should be kept in mind during the analysis of such data.
»Do the geographical boundaries và population definition of the survey & the sites being assessed match? For example, if a survey of SWs is conducted, is the type of SW included in the survey the same as the group targeted for điện thoại htc by the programme? Does the survey select SWs from specific districts or towns, while the programme covers a whole state or province? Or does the survey take a sample from areas where the smartphone htc programme does not have sites?
»How are data pooled from multiple survey sites to khung a national picture? Does the method of pooling make sense? Were sites selected purposefully or randomly? Are the data weighted khổng lồ reflect the relative kích cỡ of the population in different locations?
Indicators are derived from WHO, UNAIDS, US Government joint indicator database: Measure DHS aids Indicator Survey Measurement Database. For complete information on these indicators, see: http://www.measuredhs.com/hivdata/ind_tbl.cfm
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