Error message

  • Deprecated function: implode(): Passing glue string after array is deprecated. Swap the parameters in drupal_get_feeds() (line 394 of /var/www/indicatorregistry/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6656 of /var/www/indicatorregistry/includes/common.inc).
  • Notice: Trying to access array offset on value of type int in element_children() (line 6656 of /var/www/indicatorregistry/includes/common.inc).

(FPINT_SITE) Number of HIV service delivery points (SDP) at a site supported by PEPFAR that are providing integrated voluntary family planning (FP) services

Export Indicator

Number of HIV service delivery points (SDP) at a site supported by PEPFAR that are providing integrated voluntary family planning (FP) services
What it measures

This output indicator aims to measure progress towards integrating voluntary FP within the PEPFAR platform at the service delivery level. It captures information about whether FP integration is occurring at various HIV service delivery points within PEPFAR supported sites. Many PEPFAR sites will have numerous service delivery points within each site. For example, if one hospital receives PEPFAR support for both the HIV treatment department AND the ANC department, then the FPINT_SITE total for that one site is 2 service delivery points.

This indicator will be used to monitor coverage of HIV/FP integration at a global level. Therefore, detailed information on completion of referrals, FP service uptake, types of contraceptive methods offered on site, and other critical components of integrated programs will not be captured through this indicator but should be maintained at the site or programmatic level.

Rationale
This indicator will enable PEPFAR stakeholders to:
• Gain a basic, but essential, understanding of whether FP services are being integrated in PEPFAR-supported service delivery points.
• Identify gaps, including service contexts, countries, or regions with low levels of HIV/FP integration.
 
Inherent within this indicator is the principle that integrated HIV/FP program activities must respect a client’s right to make informed decisions about his or her reproductive life. This means that clients should have access to an appropriate and comprehensive range of contraceptive options; and/or to safer conception/pregnancy counseling depending upon their fertility desire and intentions. Judgements and personal opinions are not appropriate in a clinic setting.
Numerator

Number of service delivery points supported by PEPFAR that are providing fully integrated voluntary family planning services

Denominator

Number of total service delivery points at a site supported by PEPFAR

Calculation
How to calculate annual total:
 
N/A. Data is reported only once annually at Q4.
Method of measurement
Definition: Voluntary Family Planning Service Provision
 
To be considered as a PEPFAR-supported service delivery point that directly provides fully integrated voluntary FP services, all 3 criteria below must be met. If a service delivery point provides fewer than 3 of the services noted below, it should not be counted under this indicator.
 
The PEPFAR-supported HIV service delivery point must provide for all relevant clients, including partners in HIV discordant couples (as documented by standard operating procedures, guidelines, protocols, manuals and/or intake documents, etc.):
 
1. Assessment of voluntary FP needs through routine screening;
2. Provision of voluntary FP counseling (including safe pregnancy counseling for those wishing to become pregnant, or those who are pregnant);
3. Provision or referral of a broad range of modern contraceptive methods, in accordance with the National FP policy guidelines, for clients who voluntarily wish to delay or prevent pregnancy. It is very much preferred for methods to be available onsite. If referrals are given, they must include detailed information (e.g., facility location, hours of operation, etc.) about where methods can be accessed.
 
Assess Voluntary Family Planning Needs Through Screening (Number 1 above): In assessing FP needs, all clients as part of their routine care visit should be asked about their FP needs and practices. Depending upon the individual client and his or her needs, these can include: reproductive goals; prior pregnancies; living and family situation; FP knowledge; previously used FP methods and satisfaction with use; and any FP-related concerns. These needs should be assessed without expressing any personal biases about a client’s preference.
 
Provide Voluntary Family Planning Counseling (including Safe Pregnancy Counseling) (Number 2 above): Quality voluntary FP counseling should cover a wide range of topics that are client and context specific, and that include both safe pregnancy counseling for individuals who wish to become pregnant as well as contraception for individuals who wish to avoid, space or delay pregnancy. “FP counseling” is not the same as "FP education". Depending upon the type of FP services that are offered at PEPFAR supported site; health providers or community mobilizers may provide EDUCATION and/or COUNSELING on FP.
 
Education activities may include distribution of printed materials, group health education and community outreach efforts among other interventions. Education helps to increase general knowledge on the benefits and importance of FP and increase support for FP use, as well as to link women and their partners to other FP services, including contraceptive method provision.
 
FP counseling is an interpersonal communication between the health provider and client where topics specific to the clients’ needs are discussed to help them determine if they want to use FP and if so; to help them choose and use the FP method of their choice. HIV service providers or all levels can be trained and supported to develop or improve their skills at FP counseling. A wide array of FP counseling materials exist that can be used in PEPFAR settings; including national FP flipcharts, counseling cards and informational handouts
 
Provision or Referral of a Broad Range of Modern Contraceptive Methods (Number 3 above): Per U.S. Government legislation, and in line with national FP policies, a broad range of methods should be provided to clients, allowing them to choose the method most appropriate for them, either directly or through referral. For an SDP to be counted towards this indicator, at least three modern contraceptive methods should be available either on site or through referral. Emergency contraception is an important FP method that should be available in all HIV settings as part of FP and gender-based violence (GBV) services. Information on modern contraceptive methods can be found in the references listed at the end of this sheet. All referrals should include detailed information about where methods can be accessed (e.g., facility location, operating hours, etc.).
 
Special Considerations:
USG-supported FP and HIV/AIDS programs must adhere to the following principles:
• People living with HIV (PLHIV) and their partners should be provided with information on and be able to exercise voluntary choices about their health, including their reproductive health.
• The USG, including PEPFAR, supports a person‘s right to choose, as a matter of principle, the number, timing, and spacing of their children, as well as use of FP methods, regardless of HIV/AIDS status.
• FP use should always be a choice, made freely and voluntarily, independent of the person‘s HIV status.
• The decision to use or not to use FP should be free of any discrimination, judgment, stigma, coercion, duress, or deceit and informed by accurate, comprehensible information and access to a variety of methods.
• Access to and provision of health services, including antiretroviral treatment, for PLHIV should never be conditioned on that person's choice to accept or reject any other service, such as family planning (other than what may be necessary to ensure the safe use of antiretroviral treatment and other drug interactions).
• PLHIV who wish to have children should have access to safe and non-judgmental pregnancy counseling services.

How to review for data quality

FPINT_SITE counts the number of individual service delivery points (SDP) at a site with integrated FP services. It does not count the number of sites that integrate FP services. However, the number of sites can be extrapolated from the SDP data. See the definitions for SDP included above.

Denominator is greater than or equal to the Numerator: The total number of PEPFAR-supported service delivery points (the denominator) must be greater than or equal to the total number of PEPFAR-supported service delivery points that have integrated Family Planning (the numerator). (Note: this denominator is not collected through this indicator, therefore this data quality check would require triangulation with other indicators and additional data sources)

Reporting level

Facility by Service Delivery Point

Measurement frequency
Reporting frequency:
 
Annually
Disaggregation

Numerator Disaggregations:

Disaggregate Groups:

1. Number of Service Delivery Points by Service Delivery Area [Required]
 
Disaggregates:
 
1. • HIV Testing Services service delivery points
• Care & Treatment (includes pediatric and adolescent care and treatment) service delivery points
• Antenatal Care and/or Maternity service delivery points
• Priority Population Prevention service delivery points
• Key Populations Service Delivery Points
 
 
Denominator Disaggregations:
 
Disaggregate Groups:
 
N/A
 
Disaggregates:
 
N/A
 
 
Disaggregate descriptions & definitions:

PEPFAR-Supported Service Delivery Point at a site

A PEPFAR-supported service delivery point uses PEPFAR funds to directly provide HIV-related services. It offers one or more HIV-related services including but not limited to: HIV testing and counseling; prevention of mother-to-child transmission of HIV (PMTCT); anti-retroviral treatment (ART); screening and prophylaxis for opportunistic infections (OI); other health services for people living with HIV (e.g., positive health, dignity and prevention (PHDP), nutrition support, etc.), and prevention activities for priority populations (key populations and adolescent girls and young women). It can include fixed locations and/or mobile operations offering routine and/or regularly scheduled services. Examples include different HIV services within clinics, hospitals, health facilities and community-based organizations (government, private or NGO). Individual community health workers are not considered to be individual service delivery points. Rather, the organizations with which they are affiliated are considered to be the service delivery point(s).
 
PEPFAR service delivery points for FP/HIV integration include the following:
 
1. HIV Testing services - includes counselling (pre-test information and post-test counselling); linkage to appropriate HIV services; and coordination with laboratory services to support quality assurance and the delivery of correct results. FP services can be made available with HIV testing services, especially for key populations and adolescent girls and young women as well as for HIV serodiscordant couples. (even if FP integration is targeting key or priority populations, if occurring in HTS the integration should be documented under HTS).
2. Care and Treatment (including Pediatric and Adolescent Care and Treatment Services) – this includes services where ART is initiated and monitored.
3. Antenatal and/or Maternity services - this includes FP education and healthy timing and spacing messages in the ANC setting (when a woman in pregnant and receiving PMTCT services and/or FP counseling and method provision post-partum.)
4. Priority Population Prevention services – this includes priority population programming, such as drop in centers and prevention sites focused on adolescent girls and young women (i.e., DREAMS). FP integration can also take place across the clinical cascade for priority populations, including care and treatment which would be recorded under care and treatment service delivery point.
5. Key Population Prevention services – this includes programming for Men who have sex with men, Transgender people, Sex workers, and People who inject drugs, such as drop in centers. FP integration can also take place across the clinical cascade for key populations, including care and treatment which would be recorded under care and treatment service delivery point.

 

Explanation of the numerator

Note: a service delivery point is NOT the same as a site. There can be numerous service delivery points within one site.

Explanation of the denominator

Not collected through the data entry screened, determined by number of sites reporting service delivery area.

Further information

Indicator changes (MER 2.0 v2.2 to v2.3):

None

PEPFAR Support definition

The PEPFAR support categories of DSD and TA-SDI do not apply. To report results for this indicator, it is expected that PEPFAR provides support to the HIV service delivery area

Definition: For this indicator, a “PEPFAR supported site” should include any facility site in the PEPFAR master facility list in DATIM which also reported any programmatic target or result during the same reporting period.

Definition: For this indicator, a “PEPFAR-Supported Service Delivery Point” at a site is a service delivery point that uses PEPFAR funds to provide HIV-related services. It offers one or more HIV-related services including but not limited to: HIV testing and counseling; prevention of mother-to-child transmission of HIV (PMTCT); anti-retroviral treatment (ART) and TB/HIV services. Examples include different HIV services within clinics, hospitals, health facilities and community-based organizations (government, private or NGO). These can also include fixed locations and/or mobile operations offering routine and/or regularly scheduled services.

Guiding narrative questions:

1. Which service delivery points within supported facilities are providing integrated family planning services to people living with HIV or those at risk of acquiring HIV? (e.g., HIV prevention, HTS, C&T, PMTCT, KP, etc.)
2. What contraceptive services or methods are provided on site, and which contraceptive methods are provided through referral? Is there a tracking mechanism to ensure referrals are completed (e.g., that the client received the service)?
3. How do you ensure the quality of FP services offered at the site?