Module 3 Basic analyses Module 3 Learning objectives

Module 3: Basic analyses

Module 3: Learning objectives § Understand common analyses that calculate program coverage and efficiency § Calculate program coverage and retention

Terminology § Indicator § Program coverage § Service availability § Service utilization § Program retention

Indicator § Program element that needs tracking § Measures an aspect of a program’s performance § Measures changes over a period of time • Number of new family planning users • Number of clients currently on ART § Expressed as a number or percentage

Common Analyses § Program coverage § Extent to which a program reaches its intended target population, institution, or geographic area § Compare current performance to prior year/quarter § Compare performance between sites § Program retention § Extent to which the range of services are being delivered as initially intended so that client drop-outs are minimal

Why do we need to measure coverage? § To understand program progress § To determine if the target is reached § Clients, commodities, adherence… § To determine if one target is reached more effectively than another • Are there underserved areas/regions, subpopulations? 6

Program coverage § Extent to which a program reaches its intended target population, institution, or geographic area § Utilization: § Is the target population utilizing services, accessing commodities, being reached with services? § Availability: § Are the services available where there is a need?

Utilization calculation Percentage of the target population utilizing services # of individuals in target population using a service ---------------------- x 100 # of individuals in target population

Utilization calculation – example § No. of persons educated as of 6/12/09 = 300 § Goal for 12/31/09 = 900 300 = 0. 33 x 100 = 33% 900 § You have reached 33% of your target group with education messages

Comparison of time periods § Compare percentage achieved toward target in different time periods, different sites, etc. § Rate of increase § As of January, 70 people educated; as of June, 300 people § 300 - 70 = 230 increase in people educated § 230/6 = 38. 3 new people educated per month

Utilization of PMTCT Programs All pregnant women (2, 000) PMTCT Target (1, 000) Sought prenatal care (600) Counseled & Tested for HIV (500) Utilization = Service users Target population Utilization = 600/ 1, 000 = 0. 6 x 100 = 60%

Program coverage § Extent to which a program reaches its intended target population, institution, or geographic area § Utilization: § Is the target population utilizing services, accessing commodities, being reached with services? § Availability: § Are the services available where there is a need?

Availability calculation § Number of service outlets available per target population § Number of clinics with PMTCT per number of pregnant women § Expressed as a ratio

PMTCT clinic availability § There are 8 clinics offering PMTCT & 100, 000 pregnant women in region X. § Ratio of clinics to pregnant women 8: 100, 000 § Reduce (1: 12, 500) pregnant women § The standard recommendation is 1 clinic with PMTCT services per 10, 000 pregnant women § Clinic availability is not reaching the target

Availability + Utilization = Coverage § Service availability is 1: 12, 500 § Service availability target is 1: 10, 000 § PMTCT service utilization is 25% off the target § What can we conclude? § Service availability and utilization are too low; the program is not meeting the needs of pregnant women.

Program retention § Measures if the range of services are being delivered as initially intended § Determines program retention, i. e. , if the project is keeping clients through entire package of services • Important in clinical programs where drug adherence is an issue (TB, HIV/AIDS, immunization) and there are multiple steps (PMTCT) 16

Retention example: Immunization Utilization Enter service Polio dose 1 Completion Polio dose 2 Polio dose 3

All pregnant women (2, 000 women) PMTCT Target (1, 000) PMTCT Program Retention Sought prenatal care (600) 350 received HIVresult or no result Tested for HIV (500) 40 received prophylaxis 100 received HIV+ result

All pregnant women (2, 000 women) PMTCT Program Retention 1, 000 Sought prenatal care 500 Tested for HIV 40 received prophylaxis 350 received HIVresult 100 received HIV+ result

All pregnant women (2, 000 women) PMTCT Target (1, 000) PMTCT Program Retention Sought prenatal care (600) 350 received HIVresult Tested for HIV (500) 40 received prophylaxis 100 received HIV+ result

All pregnant women (2, 000 women) PMTCT Target (1, 000) PMTCT Program Retention Sought prenatal care (600) 350 received HIVresult or no result Tested for HIV (500) 40 received prophylaxis 100 received HIV+ result

All pregnant women (2, 000 women) PMTCT Target (1, 000) PMTCT Program Retention Sought prenatal care (600) 350 received HIVresult or no result Tested for HIV (500) 40 received prophylaxis 100 received HIV+ result

Key messages § Coverage – extent to which a program reaches its intended target population, institution, or geographic area § Retention – the extent to which the range of services are being delivered as initially intended with clients retained throughout the full package of services § It is important to look at both to fully understand your services