(PMTCT_STAT_NAT) Percentage of pregnant women with known HIV status
The risk of mother-to-child transmission (MTCT) can be significantly reduced by providing ARVs to the mother during pregnancy, delivery and (if applicable) breastfeeding. This indicator provides information on coverage of the first step in the prevention of mother-to- child transmission (PMTCT) cascade. High coverage enables early initiation of care and treatment for HIV-positive mothers. The total number of identified HIV-positive women provides the facility-specific number of pregnant women with HIV to start a facility-based PMTCT cascade. This indicator is harmonized wit GAM indicator “Percentage of pregnant women with known HIV status.”
Number of pregnant women attending antenatal clinics (ANC) and/or had a facility-based delivery and were tested for HIV during pregnancy, or already knew they were HIV positive
Number of pregnant women who attended ANC or had a facility-based delivery in the past 12 months
How to collect:
For the numerator and denominator: The data source is ANC, PMTCT and L&D program monitoring tools, such as patient registers and summary reporting forms.
Numerator: Count all women who were enrolled in ANC during the 12-month reporting period whose HIV status is known positive, or who received an HIV test result (positive or negative) during ANC. Reconcile with all women in the L&D register who whose date of delivery was in the 12 months reporting period and whose HIV status at L&D was known positive, or who received an HIV test result (positive or negative) at ANC or L&D to avoid double counting.
The numerator is a composite of the following two data components:
- The number of women with known (positive) HIV infection attending ANC for a new pregnancy over the last reporting period
- The number of women attending ANC, L&D who were tested for HIV and received results
The numerator can be summed from categories a-d below:
- Number of pregnant women with unknown HIV status attending ANC who received an HIV test and result during the current pregnancy
- Pregnant women with known HIV infection attending ANC for a new pregnancy
- Number of pregnant women with unknown HIV status attending L&D who received an HIV test and result during their current pregnancy
- Women with unknown HIV status attending postpartum services within 72 hours of delivery who were tested for the first time in the current pregnancy and received results
A “status” is defined as a confirmed test result from a test during this pregnancy (either positive or negative) or already known HIV infection at antenatal clinic entry. An indeterminate test result should not be counted or reported as a part of this indicator.
For the denominator: Count all women who were enrolled in ANC during the 12-month reporting period OR delivered at the facility (recorded in the L&D register), reconciling the latter with the former using the ANC No. to avoid double counting.
As per global guidance (see GARPR link above), it is expected that the national program can reconcile information collected from ANC with L&D records. However, in MER 2.0 the PEPFAR indicator for PMTCT_ART has been simplified to collect information only at antenatal care (ANC) sites to better align with 2016 WHO Consolidated ARV guidelines, reduce burden on data collection, and improve data quality. Therefore, in reporting this indicator PEPFAR operating units should 1) utilize the national system whether it is able avoid double counting or not and are not expected to collect or report this information through a separate system 2) if it this is not possible to report individuals from both ANC and L&D, please include an explanation in the narrative whether the data is from ANC, L&D and/or both.
Pregnant women’s HIV status should be counted only once per pregnancy. This may be difficult if national guidelines recommend testing a pregnant woman more than once during a pregnancy or if a woman seroconverts during her pregnancy and has multiple tests.
Reporting level: National and Sub-national: Data should be entered for all SNUs, regardless of PEPFAR- funded support for these geographical areas; so that the total of the sub-national number should equal the total number of national number.
Reporting frequency: Annually
Indicator changes (MER 2.0 v2.3 to v2.4): None
Data entered by: This data should be entered in DATIM by the USG country team.
Guiding narrative questions:
- Narratives should include information on how national and subnational totals have been derived for both results and targets.
- Provide context for poor performance in PMTCT_STAT coverage (Numerator/Denominator = STAT coverage) by geographic area. Include any planned activities/remedial actions.