Existence of national policies, strategies and guidelines for ART programmes
This indicator reflects whether a country has the necessary systems and strategies at the national level to implement and support the provision of ART.
In order for an ART programme to be successful, especially where stigma surrounds HIV/AIDS, political commitment is essential. At the national level there should be policies and strategies to promote ART in a comprehensive way, linking it with prevention and the strengthening of health systems, and including all groups, especially vulnerable populations. National guidelines and policies are commonly based on existing international standards or on standards that are generally agreed upon but not yet formally presented as international guidance. Without guidelines, services of unknown quality and impact may be implemented on an ad hoc basis, making it difficult to monitor and evaluate efforts.
The number of the below indicators adopted by the country in question. (a composite index; Yes = 1, No = 0).
• ART provision is an integral part of the national HIV/AIDS service provision policy.
• Existence of a functional national multisectoral HIV/AIDS management/coordination body that engages all relevant parties (MOH, NGOs, CBOs, private sector, etc.) and assists those implementing ART.
• Inclusion of people with HIV/AIDS at the policy-making level, including representation in the national coordinating body for HIV/AIDS.
• Existence of a national guideline on ART provision which incorporates the integration of treatment and prevention.
• Existence of a confidential patient-tracking system.
• Strategy to promote equitable access to ART for those who cannot afford to pay for it.
• Strategy addressing ART provision for children and young people, TB patients, and vulnerable groups such as sex workers, refugees, mobile populations, IDUs and other high-risk or hard-to-reach groups.
• Laws and regulations giving protection against discrimination for people living with HIV/AIDS
A survey among key informants at the national and district levels and in health care facilities and how to measure is used to determine whether suitable systems and strategies exist. The key informants at the national level are persons responsible for HIV/AIDS; in health facilities they include practitioners and clinic directors.
Condom type: N/A
Geographic location: N/A
HIV status: N/A
Pregnancy status: N/A
Service Type: N/A
Time period: N/A
Type of orphan: N/A
Type/Timing of testing: N/A
Vulnerability status: N/A
This indicator does not attempt to address the quality, effect or implementation of policies or guidelines. limitations: The initial focus is on determining whether policies and guidelines exist, but once they are in place the indicator should be changed to measure continued political commitment and how often guidelines are updated. Generally, policies and guidelines require critical review and updating every two to three years. This is particularly true in the field of ART, where new advances are continuously being made.