Marker Services Indicator – Strengthening HIV integration
Export Indicator
The integration of HIV and sexual and reproductive health (SRH) services: Using 'marker services'
To assess HIV and SRH integration, the indicator uses a fixed set of core HIV and SRH services, which are grouped into six different baskets, including three baskets of HIV services and three baskets of SRH services. The international community recognises that key development goals (e.g. the Millennium Development Goals) will not be achieved without ensuring expanded and ready access to HIV and SRH services. Given the overlaps and connections between these two types of services and the ability to improve access to each of them by integrating HIV and SRH within service delivery points, it is useful to assess the extent of this service integration. A better understanding of the extent of HIV and SRH integration will contribute to ongoing efforts to strengthen and improve the integration as well as the quality and availability of integrated services.
For service delivery points primarily providing HIV-related services, the numerator is the number of service delivery points that provide modern contraceptive services other than condoms to their clients/patients.
For service delivery points primarily providing SRH services, the numerator is the number of service delivery points that provide HIV testing and counselling to their clients/patients.
For service delivery points routinely providing general health services, the numerator is the number of service delivery points that provide both HIV testing and counselling and modern contraceptive services other than condoms to their clients/patients.
For service delivery points primarily providing HIV-related services, the denominator is the number of service delivery points included in the sample.
For service delivery points primarily providing SRH services, the denominator is the number of service delivery points included in the sample.
For service delivery points routinely providing general health services, the denominator is the number of service delivery points included in the sample.
Numerator / Denominator
The indicator is measured using three simple questionnaires: One questionnaire for service delivery points primarily providing HIV-related services; one questionnaire for service delivery points primarily providing SRH services; and one questionnaire for service delivery points that routinely provide general health services.
A service delivery point can include fixed locations and/or mobile operations offering routine and/or regularly scheduled services. Examples include 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.
The questionnaire for service delivery points primarily providing HIV-related services includes a follow-up question about modern contraceptive methods other than condoms. There are two options for this question. Option 1 uses modern contraceptive methods other than condoms as a proxy. Option 2 provides respondents the opportunity to list the modern contraceptive methods other than condoms that are available.
Annual, Biannual
Geographic location: Rural, Urban
The primary strength of this indicator is its ability to quickly and easily provide a ‘snapshot’ of the current situation. For example: Is a core SRH service available at service delivery points providing HIV-related services and vice versa? Given the currently low level of integration between HIV and SRH services, the proxy measures used in this indicator provide valuable information on the situation, which is useful for a wide audience, ranging from policy makers to programme implementers.
Over the long term, as integration between HIV and SRH services become more common, the value of this indicator will diminish. The use of marker services as proxy measures will not provide detailed information about specific models of integration that are contributing to more effective approaches to service delivery.
Sexual & reproductive health and HIV linkages: evidence review and recommendations at http://www.who.int/reproductivehealth/publications/linkages/hiv_2009/en/
Rapid Assessment Tool for Sexual and Reproductive Health and Linkages at http://srhhivlinkages.org/wp-content/uploads/2013/04/rapidassessmenttool...