Number of new health care workers who graduated from a pre-service training institution within the reporting period

Export Indicator

Number of new health care workers who graduated from a pre-service training institution within the reporting period
What it measures

This indicator is meant to capture the spirit of PEPFAR legislation and will be used in conjunction with other indicators and measures to report to congress on PEPFAR contributions to building the national health workforce.


It is widely acknowledged that the lack of trained health workers is a major barrier to scaling up HIV/AIDS services. The lack of a sufficient workforce in the PEPFAR countries presents a serious challenge not only to HIV/AIDS programs but to every area of health.

PEPFAR has a new legislative goal to produce at least 140,000 new health workers in PEPFAR countries by the end of FY 2013. The intent of this goal is for PEPFAR to support the production of health workers in each country through pre-service training.

The data will tell us the number of new health care workers who are available to enter the health work force each year as a result of full or partial PEPFAR support.


A count of the number of new health care workers who graduated from a pre-service training institution or program




Not applicable

Method of measurement

The number is the sum of new health care workers from the host country who graduated from a pre-service training institution within the reporting period with full or partial PEPFAR support. Individuals may be in pre-service training over a number of years, but will not count as graduated until they have completed their program. Local pre-service institutions may support other host country nationals under their program but those graduates should not be included in a country’s report on this indicator.

Training under this indicator is defined as “pre-service” training – the training of “new” health care workers (see definition below). All training must occur prior to the individual entering the health workforce in his or her new position. A health care worker who transitions to another position (e.g., nurse completes medical school to become a doctor) shall be counted as a “new” health care worker for the purposes of this indicator. However, the intent of PEPFAR program is to expand the number of workers in the workforce.

Pre-service training institutions are university-based or affiliated schools of medicine, nursing, public health, social work, laboratory science, pharmacy, and other health-related fields. Non-professional or paraprofessional training would be any accredited and nationally recognized pre-service program that is a requirement for this cadre’s entry into the workforce.

“In-service” and “continuing education” training should not be included in the count for this indicator, but continue to be encouraged by PEPFAR. These types of training may be captured by other indicators.

A pre-service training program must be nationally accredited, or at the minimum meet national and international standards. The program must also have specific learning objectives, a course curriculum, expected knowledge, skills, and competencies to be gained by participants, as well as documented minimum requirements for course completion. The duration and intensity of training will vary by cadre; however, all training programs should have at a minimum the criteria listed above.

Individuals may be in training over many reporting periods; however, only participants who have successfully completed their training should be counted. Successful completion of training may be documented by diploma or certificate. Individuals not meeting these documented requirements should not be counted in this indicator.

“Health workers” refers to individuals involved in safeguarding and contributing to the prevention, promotion and protection of the health of the population (both professional and auxiliary-professionals). The categories below describe the different types of health workers to be considered under this indicator. This not an exhaustive list of all health workers and position titles may vary from country to country.

For the purposes of this indicator, health workers include the following:

1) Clinical health workers – Clinical health workers play clinical roles in direct service delivery and patient care: a) Clinical professionals, including doctors, nurses, midwives, laboratory scientists, pharmacists, social workers, medical technologists, and psychologists; They usually have a tertiary education and most countries have a formal method of certifying their qualifications.

b) Clinical officers, medical and nursing assistants, lab and pharmacy technicians, auxiliary nurses, auxiliary midwives, T&C counselors. They usually have completed a diploma or certificate program according to a standardized or accredited curriculum and support or substitute for university-trained professionals.

2) Non-clinical health workers - Non-clinical workers do not play clinical roles in a health

Measurement frequency



Age group:

Condom type: N/A

Education: N/A

Gender: N/A

Geographic location: N/A

HIV status: N/A

Pregnancy status: N/A

Sector: N/A

Service Type: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Type/Timing of testing: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

This indicator does not measure the quality of the pre-service training, nor does it measure the outcomes of the training in terms of the competencies of individuals trained, nor their job performance. This indicator does not measure the placement or retention in the health workforce of trained individuals from their host country.

Pre-service training is an essential component of human resources for health that is planned as part of an overall HRH strategy, which links the production of new health workers with service delivery needs and health systems capacity to recruit and retain newly trained health workers. 

Data collected by this indicator at the national level can be combined with survey data, workforce vacancy rate data, or other human resources data looking at the number of health workers per 1000 population in order to gain an understanding of the overall impact of pre-service training programs on workforce expansion.

Further information