Attachment_J.15_RHITES_ACHOLI__Indicator_List.pdf

J.15: USAID/RHITES ACHOLI Mandatory Indicators

Multiple Global Health Initiative including but not limited to EPCMD, PEPFAR and PMI designate Uganda as a “priority” country, and as a result, these Global Health Initiatives will measure direct impact and outcomes using indicators under this program. The following list of 66 indicators are collectively called “USAID/RHITES Mandatory Indicators”.

The below list of Mandatory indicators includes two levels of indicators: Core and Contextual. USAID recognizes that meeting targets on certain indicators are outside the Contractors manageable interest. Therefore, the award fee will be linked to achievement of

Core Indicators (highlighted in yellow below and pulled out in a summary table). The rest of the mandatory indicators are often required by initiatives/funding streams and called Contextual Indicators. Offerors may also include additional indicators to measure additional results as needed, e.g. Custom Indicators.

During implementation, the Contractor shall work with the COR to complete a Baseline, and the results of the Baseline may provide for adjustments to targets in the AMELP subject to COR approval. Additionally, PEPFAR allocates targets on an annual basis and has historically needed greater flexibility in activity implementation. Out year targets for TX_NEW, TX_PLVS, HTC_TST, HTC_TST_Positives, and VMMC_CIRC are dependent PEPFAR negotiations and will be subject to change.

Core Indicators Baseline Year One Target

Year Two Target

Year Three Target

Year Four Target

Year Five Target

Percent of USG‐supported primary health care (PHC) facilities that submitted routine reports on time

TBD 60% 70% 80% 90% 100%

Percent of joint quarterly health sector performance review meetings held TBD 85% 90% 95% 100% 100% TX_NEW: Number of adults and children newly enrolled on antiretroviral therapy (ART)

1313 2332 TBD TBD TBD TBD

TX_PVLS: Percentage of ART patients with a viral load result documented in the medical record and or laboratory information systems (LIS) within the past 12 months with a suppressed viral load (<1000 copies/ml)

N/A 90% 90% 90% 90% 90%

HTC_TST: Number of individuals who received HIV Testing and Counseling (HTC) services for HIV and received their test results

37540 38488 TBD TBD TBD TBD

HTC_TST_Positives: Percentage of newly identified positives from HCT-TEST 1770 1446 TBD TBD TBD TBD VMMC_CIRC: Number of males circumcised as part of the voluntary medical male circumcision (VMMC) for HIV prevention program within the reporting period

1376 8244 TBD TBD TBD TBD

Percent of pregnant women received IPT 2 plus (IpT2 +) among all pregnant women visited ANC clinics

68.8% 70% 72.5% 75% 77.5% 80%

TB Case Detection Rate 44% 50% 55% 60% 65% 70% TB Cure Rate 60% 65% 70% 75% 80% 85%

Health unit delivery rate 52.5% 55% 60% 65% 70% 75% Percent of children < 1 years immunized 72.5% 75% 80% 85% 90% 90% Percentage of USG assisted service delivery sites providing family planning services according to national guidelines

TBD 50% 75% 100% 100% 100%

Percent of children <5 reached with nutrition interventions with USG support TBD 65% 70% 75% 80% 80% Percent of USAID-supported health facilities conducting hygiene audits and action planning

TBD 30% 60% 80% 100% 100%

Indicator Indicator Definition Data Source Disaggregated by

HSS

1. Percent of USG‐supported primary health care (PHC) facilities that submitted routine reports on time, disaggregated by public sector and private sector, and disaggregated by numerator and denominator

The total number of USG‐supported PHCs that submitted all routine reports on time over the past 12 months according to national HIS policy.

HMIS Public/private

2. Percent of joint quarterly health sector performance review meetings held

IP Reports District

3. Percent of districts whose annual work-plan reflect IP support by district

IP Reports District

4. Availability of 41 tracer medicines in facilities visited Essential Medicines and Health Supplies (15 medicines) ARV (8 medicines) TB ( 2 medicines) LAB (7 health supplies and diagnostics)

REPRODUCTIVE MATERNAL NEONATAL AND CHILD HEALTH (RMNCH- 9

Medicines/supplies)

Pharmaceutical Information Portal

Facility

5. HRH_CURR: Number of health workers that are financially supported by PEPFAR at community sites and at the above site level.

IP Reports Cadre by level

6. HRH_STAFF: Number of health care workers (regardless of funding source) at a PEPFAR funded clinical facility (with PEPFAR supported staff disaggregated)

IP Reports Clinical workers;

Management workers;

Clinical Support workers;

Social Services Workers; Lay workers; Other

7. EMR_SITE: Number of service delivery points that utilize a patient level electronic medical record system

IP Reports Service Delivery Points (HIV Care and Treatment, PMTCT, HTC, EID)

HIV Care and Treatment (for further detail on PEFPAR indicators, please see attachment on Current MERS Indicators)

8. FPINT_SITE: Percentage of HIV service delivery points supported by PEPFAR that are directly providing integrated voluntary family planning services

Numerator: Number of service delivery points supported by PEPFAR that are directly providing integrated voluntary family planning services.

Denominator: Total number of PEPFAR-supported PMTCT, Care and Treatment HIV service delivery points.

A service delivery point that directly provides integrated voluntary family

IP Reports None planning services must provide all 3 criteria below to all relevant clients. 1) Assessment of voluntary family planning needs through routine screening; 2) Provision of voluntary family planning counseling; 3. Provision 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 either directly or through referral that includes detailed information about where methods not available at the site can be accessed.

If a service delivery point provides fewer than 3 of the services noted below, it should not be counted.

9. TX_NEW: Number of adults and children newly enrolled on antiretroviral therapy (ART)

Numerator: Number of adults and children newly enrolled on ART Denominator: N/A.

The numerator is generated by counting the number of adults and children who are newly enrolled in ART in the reporting period, in accordance with the nationally approved treatment protocol (or WHO/UNAIDS standards).

Other HIV-positive pregnant women taking other ARV regimens for PMTCT in this indicator, including those taking maternal triple ARV prophylaxis (provided with the intention to stop at the end of the breastfeeding period), maternal AZT (prophylaxis component of WHO Option A during pregnancy and delivery), and single-dose nevirapine (with or without tail) should not be included in this indicator.

HMIS Age, Male, Female

10. TX_CURR: Number of adults and children with HIV infection currently receiving antiretroviral therapy (ART)

Numerator: Number of adults and children with HIV infection receiving antiretroviral therapy (ART) Denominator: N/A.

The current on ART count equals the number of adults and children with HIV infection who ever started ART minus those patients who are not currently on treatment at the end of the reporting period. Other HIV-positive pregnant women taking other ARV regimens for PMTCT only in this indicator, including those taking maternal triple ARV prophylaxis (provided with the intention to stop at the end of the breastfeeding period) and single-dose nevirapine (with or without tail) should not be included. ART taken only for the purpose of post-exposure prophylaxis is NOT included in this indicator.

HMIS Age, Male, Female

11. TX_RET: Percentage of adults and children in the cohort, who are still alive and on treatment at 12 months after initiating ART

Numerator: Number of adults and children who are still alive and on treatment at 12 months after initiating ART Denominator: Total number of adults and children who initiated ART in the 12 months prior to the beginning of the reporting period, including those who have died, those who have stopped ART, and those lost to follow-up.

The reporting period is defined as a continuous 12-month period that ends within PEPFAR reporting requirements. A 12-month outcome is defined as the outcome, i.e., whether the patient is still alive and on ART, dead or lost to follow-up, 12 months after starting. The numerator does not require patients to have been on ART continuously for the 12-month period.

Patients may be included in the numerator (and denominator) if they have missed an appointment or drug pick-up or temporarily stopped treatment

HMIS Pregnant women, Breastfeeding during the 12 months since initiating treatment, as long as they are recorded as still being on treatment at month 12. At the facility level, patients who have transferred in with a known treatment initiation date that falls within the reporting period should be counted. Conversely, patients who transferred out of the facility should not be counted in that facility’s cohort.

The denominator is the total number of adults and children in the (monthly) ART start-up groups who initiated ART at a point 12 months prior to the beginning of the reporting period, regardless of their 12month outcome.

(i.e., died, LTFU, stopped); this includes those “New” on ART as well as those who “Transferred In” if they have a cohort-start date within the reporting period of interest.

12. TX_PVLS: Percentage of ART patients with a viral load result documented in the medical record and or laboratory information systems (LIS) within the past 12 months with a suppressed viral load (<1000 copies/ml)

Numerator: Number of adult and pediatric ART patients with a viral load result documented in the patient medical record within the past 12 months.

Denominator: Number of adults and children on ART for at least 6 months whose medical records were reviewed.

Data for the numerator should be generated by counting the number of patients with charts reviewed who have a viral load result documented in the medical record within the last 12 months. Review of the medical record is required to determine whether any viral load result is present. If yes, review of the time period of the result is necessary to determine if the viral load was collected within the past 12 months. The numerator requires that adult and child patients must be alive and on ART for at least 6 months. The numerator does not require patients to have been on ART continuously.

Patients will be included in the numerator if they have missed an appointment or drug pickup or temporarily stopped treatment as long as they are still taking ART. The patients who have died, stopped treatment, or been lost to follow-up should not be sampled, and therefore, will not be included in the numerator. The denominator is the number of sampled adults and children who have been on ART at least 6 months (excluding those who have died, stopped ART, or been lost to follow-up) with charts reviewed.

Moving to HMIS Age, Male, Female

13. TB_STAT: Percentage of registered new and relapsed TB cases with documented HIV status, during the reporting period.

Numerator: Number of registered new and relapse TB cases with documented HIV test results, during the reporting period.

Denominator: Total number of registered new and relapsed TB cases, during the reporting period.

The numerator will be generated by counting the number of registered new and relapsed TB cases with documented HIV test results during the reporting period. This will include all registered new and relapse TB cases with documented HIV test results either via testing at diagnosis and registration or via documented previously known HIV-positive test results during the reporting period.

HMIS Age, Male, Female

14. TB_ART: Percentage of registered TB cases with documented HIV-positive status who start or continue ART during the reporting period.

Numerator: The number of new and relapsed registered TB cases with documented HIV-positive status who are on ART during the reporting period.

Denominator: The number of new and relapsed registered TB cases with

HMIS Age, Male, Female documented HIV-positive status during the reporting period.

The numerator will include all registered new and relapsed TB cases who are HIV-positive that are on ART, including PLHIV who newly initiate ART after TB case registration and those who are already on ART at the time of TB case registration, during the reporting period. The denominator includes all registered new and relapsed TB cases that tested HIV-positive at registration or had documented previously known HIV-positive status, during the reporting period.

15. TB_SCREENDX: Number of PLHIV in HIV clinical care who were screened for TB symptoms at the last clinical visit.

Numerator: The number of PLHIV in clinical care who were screened for TB.

Denominator: The total number of PLHIV in care.

HMIS Age, Male, Female

Prevention of Mother to Child Transmission of HIV (for further detail on PEFPAR indicators, please see attachment on Current MERS Indicators)

16. PMTCT_ART: Percentage of HIV-positive pregnant women who received antiretrovirals to reduce risk for mother- to-child-transmission (MTCT) during pregnancy and delivery

Numerator: Number of HIV-positive pregnant women who received antiretrovirals (ARVs) to reduce risk of mother-to-child-transmission during pregnancy Denominator: Number of HIV-positive pregnant women identified in the reporting period (including known HIV-positive at entry)

This denominator includes a sum of categories a-d below, at USG-supported sites:

a) Number of pregnant women who were tested and received an HIV+ result at ANC

b) Pregnant women known to be HIV-positive attending ANC for a new pregnancy

c) Pregnant women tested during L&D and received a new HIV+ result

d) Women with unknown HIV status attending postpartum services within 72 hours of delivery who were tested for HIV and received their HIV + result

Due to the way in which data is collected and reported, some level of duplication may be inevitable.

HMIS None

17. PMTCT_STAT: Percentage of pregnant women with known HIV status (includes women who were tested for HIV and received their results)

Numerator: Number of pregnant women who were tested for HIV and know their results plus number of pregnant women with known HIV status at entry to services.

Denominator: Number of new ANC and L&D clients.

The numerator can be summed from categories a-d below:

a) Number of pregnant women with unknown HIV status attending ANC who received an HIV test and result during the current pregnancy

b) Pregnant women with known HIV infection attending ANC for a new pregnancy

c) Number of pregnant women with unknown HIV status attending L&D who received an HIV test and result during their current pregnancy

d) 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

HMIS

A “known HIV status” is defined as a confirmed positive test result from a test during this pregnancy, an already known positive test result, or a confirmed negative test result during the current pregnancy. An indeterminate test result should not be counted or reported as a part of this indicator.

18. PMTCT_EID: Percentage of infants born to HIV-positive women who had a virologic test done within 12 months of birth

Numerator: Number of infants who had a virologic HIV test within 12 months of birth during the reporting period Denominator: Number of HIV-positive pregnant women identified in the reporting period (including known HIV-positive women at entry into PMTCT).

A virologic test is a test used for HIV diagnosis in infants up to 18 months of age. The most commonly used form of virologic testing is HIV DNA PCR on dried blood spots (DBS). Tests used for clinical monitoring of children on ART, such as viral load quantification, should not be included. Infants tested should be counted once, even if they have had more than one virologic test done during the reporting period. Only infants who have received a virologic test by 12 months of birth should be counted and reported. Number of HIV-positive pregnant women identified during the reporting period serves as a proxy for the number of infants born to HIV-positive women.

HMIS Male, Female

19. PMTCT_FO: Final outcomes among HIV exposed infants registered in the birth cohort

Numerator: Number of HIV-exposed infants with a documented outcome by 18 months of age (collection of 18 month outcomes is recommended at 24 months of age) Denominator: Number of HIV-exposed infants registered in the birth cohort at any time between 0 and 18 months of age (including transfers-ins).

The 18 month outcomes are collected at 24 months for the following reasons: 1) it allows for children who present several months late to their 18 month visit to be included in the numerator and 2) cohort reporting is easiest when monthly reporting by facilities is used and where the birth month and the reporting month are the same calendar month.

The denominator includes those “Transferred In” and those “Transferred Out”. The inclusion of Transfers-In/Out provides a quality check to ensure that all exposed infants have an outcome assigned to them during the reporting process such that the sum of the numerator disaggregation equals the denominator. However when interpreting this indicator across multiple sites at a district level, it is necessary to exclude “Transferred Out” from the denominator to avoid double counting outcomes for HIV-exposed infants who transfer between sites.

HMIS Male, Female

HIV counselling and testing (for further detail on PEFPAR indicators, please see attachment on Current MERS Indicators)

20. HTC_TST: Number of individuals who received HIV Testing and Counseling (HTC) services for HIV and received their test results.

Numerator: The number of individuals who received HIV Testing and Counseling (HTC) services for HIV and received their test results.

Denominator: N/A.

A minimum provision of the following services is required for adequate data collection for this indicator: counseling, testing, return, and receipt of test results. It includes repeat testers and provides information on the number of times HTC services were delivered, rather than the number of unique

HMIS Age, Male, Female, Status (positive/negative) individuals who received HTC services.

VMMC (for further detail on PEFPAR indicators, please see attachment on Current MERS Indicators)

21. VMMC_CIRC: Number of males circumcised as part of the voluntary medical male circumcision (VMMC) for HIV prevention program within the reporting period

Numerator: Number of males provided with voluntary medical male circumcision.

Denominator: N/A Males who are provided with circumcision as part of the VMMC for HIV prevention program and in accordance with the WHO/UNAIDS/Jhpiego Manual for Male Circumcision Under Local Anesthesia, or other WHO normative guidance (in the case of device-based VMMC), and per national standards in the reporting period meet the definition for the numerator.

Males who are provided with circumcision using a medical device in the reporting period also meet the definition for the numerator as long as the device used is recognized or pre-qualified by WHO.

HMIS None

HIV PREVENTION (for further detail on PEFPAR indicators, please see attachment on Current MERS Indicators)

22. GEND_GBV: Number of people receiving post -GBV clinical services based on the minimum package.

Numerator: Number of people receiving post-GBV care Denominator: N/A GBV is defined as any form of violence that is directed at an individual based on his or her biological sex, gender identity or expression, or his or her perceived adherence to socially-defined expectations of what it means to be a man or woman, boy or girl. It includes physical, sexual, and psychological abuse; threats; coercion; arbitrary deprivation of liberty; and economic deprivation, whether occurring in public or private life. GBV is rooted in gender-related power differences, including social, economic and political inequalities. It is characterized by the use and abuse of physical, emotional, or financial power and control.

IP Reports Age, Male, Female

23. PrEP_NEW: Number of individuals who have received antiretroviral pre-exposure prophylaxis in the reporting period (PrEP) to prevent HIV infection in the reporting period.

See MER Indicators IP Reports Age, Male, Female

24. KP_PREV: Percentage of key populations reached with individual and/or small group level HIV preventive interventions that are based on evidence and/or meet the minimum standards required

Numerator: Number of key populations reached with individual and/or small group level preventive interventions that are based on evidence and/or meet the minimum standards required.

Denominator: Total estimated number of key populations in the catchment area.

This indicator provides information on the total number of unduplicated individuals that received and completed individual-level and/or small-group level interventions. These interventions are based on evidence and/or meet the required minimum standards. The numerator will be generated by counting the number of duplicated individuals from an activity defined target population who are reached with and complete a prevention intervention designed for the intended key population. The denominator will be computed from geographic region from which persons come to receive HIV prevention services, or from which persons are being recruited into HIV prevention services or using key populations estimates for sub districts/districts is available. Data will be collected at every encounter/point of service and aggregated in time for reporting. Data will be reviewed

IP Reports Age, Male, Female regularly for the purposes of program management, to monitor progress towards achieving targets, and to identify and correct any data quality issues.

25. PP_PREV: Percentage of priority populations reached with individual and/or small group level HIV preventive interventions that are based on evidence and/or meet the minimum standards required.

Numerator: Number of priority populations reached with individual and/or small group level preventive interventions that are based on evidence and/or meet the minimum standards required.

Denominator: Total estimated number of key populations in the catchment area.

This indicator provides information on the total number of unduplicated individuals that received and completed individual-level and/or small-group level interventions. These interventions are based on evidence and/or meet the required minimum standards. The numerator will be generated by counting the number of duplicated individuals from an activity defined target population who are reached with and complete a prevention intervention designed for the intended key population. The denominator will be computed from geographic region from which persons come to receive HIV prevention services, or from which persons are being recruited into HIV prevention services or using key populations estimates for sub districts/districts is available. Data will be collected at every encounter/point of service and aggregated in time for reporting. Data will be reviewed regularly for the purposes of program management, to monitor progress towards achieving targets, and to identify and correct any data quality issues.

IP Reports Age, Male, Female

MALARIA

26. Percent of pregnant women received IPT 2 plus (IpT2 +) among all pregnant women visited ANC clinics

In areas of moderate-to-high malaria transmission, IPTp with SP is recommended for all pregnant women at each scheduled antenatal care visit. WHO recommends a schedule of four antenatal care visits. - The firstIPTp-SP dose should be administered as early as possible during the 2nd trimester of gestation - Each SP dose should be given at least 1 month apart

- The last dose of IPTp with SP can be administered up to the time of delivery, without safety concerns.

Numerator: Number of pregnant women who receive IPTp2+ under observation Denominator: Total number of antenatal clinic visits (N/D X 100= percentage)

HMIS Districts

27. Percent of pregnant women provided with ITNs through during

ANC

Numerator: Number of pregnant women who receive ITNs

Denominator: Total number of pregnant women with first antenatal clinic visits (N/D X 100= percentage)

HMIS/LQAS District

28. Percent of children U 5s with a fever who receive a diagnostic test (Microscopy or RDT) at the health facility

Numerator: Number of children < 5 years of ages with a fever who receive a diagnostic test (Microscopy or RDT) for malaria at health facilities

HMIS Districts

Denominator: Total number of children < 5 years of ages with a fever visited health facilities (N/D X 100= percentages)

29. Percent of children 0-23 months who had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset fever

Numerator: Number of children 0-23 months who had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset fever

Denominator: Total number of children 0-23 months who had fever in the two weeks preceding the survey and received treatment with ACTs within 24 hours of onset fever

(N/D X 100= percentages)

LQAS Districts

30. Percent of Malaria confirmed cases (Microscopy and RDT) < 5 years

Numerator: Number of children < 5 years of ages with fever tested positive for malaria Denominator: Total number of children < 5 years of ages with fever (N/D X 100= percentage)

HMIS Districts

31. Proportion of Malaria Cases with a confirmed diagnosis before provision of treatment

Numerator: Number of people with fever tested positive for malaria who receive treatment with ACTs Denominator: Total number of people with fever tested positive for malaria at health facilities.

HMIS Districts

Maternal/Newborn Health

32. Total number of pregnant women attending ANC 1 HMIS District

33. Percentage of Pregnant women received Iron/Folic Acid at first

ANC

HMIS District

34. Percentage of pregnant women attending ANC at least 4 times Percentage of mothers with children 0-11 months who attended ANC at least 4 times during last pregnancy.

Numerator: Number of mothers with children 0-11 months who attended ANC at least 4 times during last pregnancy.

Denominator: Total number of mothers with children 0-11 months in the survey. The target group will be mothers of children 0-11 months.

Unit of measure: Percentage

HMIS District

35. Number (and percentage) of mothers who attend PNC visit by 6 weeks postpartum

HMIS District

36. Health Unit Delivery Rate HMIS District

37. Percent of deliveries under skilled attendance WHO defines a skilled provider is a health professional such as midwife, doctor, clinical officer, or nurse, who has been trained to proficiency in the skills needed to manage childbirth.

Numerator: Number of mothers of children 0-11 months who were assisted by a skilled health worker during last delivery.

Denominator: Total number of mothers of children 0-11 months in the survey. The target group in the survey will be mothers of children 0-11 months.

Unit of measure: Percentage

LQAS District

38. Number of newborns not breathing who were resuscitated in USG-supported programs

Number of newborns not breathing at birth who were resuscitated in USG‐ supported programs.

Resuscitation includes drying, wrapping, stimulation, and bag/mask.

HMIS District, facility

39. Percent of newborns breastfed within one hour HMIS District

40. Number of women giving birth who received an utertonic in the third state of labor (or immediately following birth)

Number of women who gave birth in the last year who received uterotonics in the third stage of labor through USG-supported programs Uterotonic could include oxytocin or misoprostol. Uterontonics represent one element of active management of third stage of labor (AMTSL)

TBD District, facility

Child Health

41. Percent of children < 5 years immunized Numerator: Number of children who have received all three DPT3 boosters’ (pentavelant) vaccinations by 12 months through USG-assisted programs in catchment area.

Denominator: Total number of children expected to have received all three DPT3 boosters’ (pentavelant) vaccinations by 12 months through USG-assisted programs in catchment area.

HMIS District

42. Percent of children <5 who are fully immunized This includes measles LQAS District

43. Number of children < 5 years who received deworming 2nd dose Numerator: Number of children < 5 years who received deworming 2nd dose Denominator: N/A

HMIS District

44. Percent of children aged 6-59 months receiving 2 doses of Vitamin A supplementation

Numerator: Number of children under five who received Vitamin A from USG-supported programs in the last six months Denominator: N/A

HMIS District

45. Number of cases of child diarrhea treated in USG-supported programs

Numerator: Number of cases of child diarrhea treated in USG-supported programs Denominator: N/A

HMIS District

Family Planning

46. Number of family planning users by method (new users) Number of new clients provided with Family Planning services

HMIS Age, Type of Family Planning method, public (level of public) and private

47. Number of family planning users by method (revisits) Number of revist clients provided with Family Planning services

HMIS Age, Type of Family Planning method, public (level of public) and private

48. Percentage of USG assisted service delivery sites providing family planning services according to national guidelines

Numerator: Number of USG-assisted service delivery sites providing FP information and/or services.

Denominator: Number of SDPs planned to receive USG assistance over life of project. USG-assisted: Funded with congressionally-earmarked FP funds for any kind of assistance.

HCII and III should be providing at least three methods; HCIV and above should be providing at least five methods.

Service Delivery Points: Clinics, hospitals, facilities (government, private or NGO/FBO) pharmacies, and/or social marketing sales points. Does not include community health workers (CHWs).

FP counseling: FP information and/or FP counseling provided in the context of a visit with a FP service provider. FP Services: Provision of FP methods and or FP referrals.

IP Reports

None

49. Average stockout rate of contraceptive commodities at family Stock out: The absence, regardless of duration, at an SDP of a contraceptive TBD District, facility planning service delivery points product (e.g. oral contraceptive pill or injectable) or related supplies (e.g. for insertion of IUDs or implants, or male and female sterilizations) that prevents the SDP from offering that method. USG-assisted: Any FP assistance that is funded with POP funds from the GHP account. Service Delivery Points: Any facility that provides a contraceptive method to end users. Examples include clinics, hospitals, facilities (government, private or NGO/FBO), pharmacies, and/or social marketing sales points. Does not include community health workers (CHWs). Whether a SDP is expected to offer a particular contraceptive method may be determined from standard treatment guidelines or other national policy/program documents. Both the numerator and denominator should be reported to allow aggregation across countries. The numerator is the number of SDPs that experienced a stock out of any contraceptive method at any time during the year, regardless of duration or number of methods that were out-of-stock. If an SDP is stocked out of different methods at the same or different times in the reporting period, or if an SDP experiences stock outs of a method multiple times in the reporting period, this should be reported as a single SDP that experienced a stock out during the period. In other words, an SDP should only be counted once in the numerator. The denominator includes the number of monitored SDPs that are expected to provide one or more contraceptive method(s).

SDPs should be direct or indirect beneficiaries of any kind of USG-funded FP assistance, regardless of whether it includes contraceptive donations or supply chain strengthening.

50. Couple years of protection The estimated protection provided by family planning methods during a one-year period, based upon the volume of all contraceptive methods provided to clients during that period.

The CYP is calculated by multiplying the quantity of each method distributed to clients by the USAID conversion factor, to yield an estimate of the duration of contraceptive protection provided per unit of that method. The CYPs for each method are then summed over all methods to obtain a total CYP figure. CYP refers to the total number of years of contraceptive protection provided to a country's or community's FP population. Computed from the volume of all contraceptives provided direct to clients using USAID CYP factors.

IP Reports District

51. Number of USG assisted community health workers providing family planning information, referrals, and/or services

Number of USG assisted community health workers providing family planning information, referrals, and/or services.

IP Reports District

52. Percent of clients who report satisfaction with services provided in public facilities within program area

Numerator: Number of USG-assisted clients who report satisfaction with services provided in public facilities within program area Denominator: Total number of USG-assisted clients who report satisfaction with services provided in public facilities within program area

LQAS None

Nutrition

53. Percent of children (0-59 months) reached by USG-supported nutrition programs

Children under five: Children under five years are those zero to 59 months of age. They are often targeted by US-supported activities with nutrition objectives.

IP Reports <2 and 2-5 years of age;

By intervention

Reached by nutrition programs: A child can be counted as reached if s/he receives one or more of the following nutrition-specific interventions directly or through the mother/caretaker:

Behavior change communication interventions that promote essential infant and young child feeding behaviors including:

Immediate, exclusive, and continued breastfeeding;

Appropriate, adequate and safe complementary foods from

6 to 24 months of age

Vitamin A supplementation in the past 6 months

Zinc supplementation during episodes of diarrhea

Multiple Micronutrient Powder (MNP) supplementation

Treatment of severe acute malnutrition

Treatment of moderate acute malnutrition

Direct food assistance of fortified/specialized food products (i.e. CSB+, Supercereal Plus, RUTF, RUSF, etc)

Missions and IPs who have a strong justification may opt out of the requirement to disaggregate this indicator into the seven interventions and two sex disaggregates. For example, OUs may opt out if IPs rely on the government health system to collect this data and these disaggregates are not included in that system. The reason should be noted in the online PPR reporting database. In this case, Missions may report solely the total number of children under 5 reached. If only some disaggregates are available then Missions should report both the total number and the number for each available disaggregate.

Projects that support Growth Monitoring & Promotion (GMP) interventions should report children reached under the BCC disaggregate (#1).

Count each child once, even if reached by multiple nutrition related interventions.

54. Percent of children 6-23 months receiving minimum acceptable diet.

LQAS District

55. Number of individuals receiving nutrition related professional training through USG-supported programs

Number of people (health professionals, primary health care workers, community health workers, volunteers, non-health personnel) trained in child nutrition through United States Government (USG)-supported programs during the reporting year.

IP Reports None

56. Number of facilities with established capacity to manage acute under-nutrition

A health facility may include government health clinics, private clinics as well as clinics run by community-based organizations or local Non-Governmental Organizations (NGOs). Many health facilities are set up by International NGOs (INGOs), who may also provide staff training. As long as a local entity is actually running the facility, it can be counted here, even if a non-local

IP Reports Facilities entity was influential in setting up, funding, or training the staff. An “established capacity to manage acute under nutrition” indicates the organization has a program with established procedures, methods and appropriate materials (resources, trained staff, etc.) to address acute under nutrition. An example of this could be a facility that meets the criteria on the National Protocol in the Community Management of Acute Malnutrition (CMAM) program. This indicator is asking how many health facilities have this type of management capacity. NOTE: This indicator should include all currently capable health facilities, and not only those who achieved the capability during this fiscal year. The intention is to reflect the current coverage of capable health facilities during each given fiscal year

57. Number of pregnant and lactating women reached with nutrition interventions through USG supported programs

The 1,000 days between pregnancy and a child’s second birthday are the most critical period to ensure optimum physical and cognitive development.

Pregnant women: This indicator captures the reach of activities that are targeted towards women during pregnancy, intended to contribute to the health of both the mother and the child, and to positive birth outcomes. A separate standard indicator will count the number of children under 2 reached by USG-supported programs (insert indicator # here --currently # 2).

Nutrition interventions: A pregnant woman can be counted as reached if she receives one or more of the following interventions:

Iron and folic acid supplementation

Counseling on maternal and/or child nutrition

Calcium supplementation

Multiple micronutrient supplementation

Direct food assistance of fortified/specialized food products (i.e.

CSB+, Supercereal Plus, RUTF, RUSF, etc)

If possible, the Mission and IPs should also disaggregate this indicator by age (number of women < 19, number of women >+ 19) to determine whether projects are reaching this particularly vulnerable adolescent population.

Iron and folic acid (IFA) supplementation is a commonly implemented intervention for pregnant women, often with broad coverage. Ideally, however, pregnant women should receive nutrition interventions beyond IFA, within a comprehensive ANC program informed by the local epidemiology of nutrient deficiencies. Nutrition interventions for women are often delivered at the facility level, included in the package of antenatal care, but they may also be delivered through community-level platforms, such as care groups or community health extension activities.

A woman is reached with IFA if she receives the IFA according to national

IP Reports District guidelines regardless of the number of days she adheres. If a woman only receives Iron or only Folic Acid, she would not be counted as reached.

If the IP contributed to “supply” side activities (e.g. procuring the commodity), then the women reached through these interventions can be counted as reached. If the activities are only “demand” creation (e.g.

awareness-raising), then they should not be counted under this indicator.

The nutrition interventions during pregnancy listed above affect neonatal health outcomes such as low birth weight, small for gestational age, preterm birth, and cretinism. Nevertheless, pregnant women reached by these interventions should be counted under this indicator, and not counted as a “child reached” under the two other Nutrition PPR indicators: (1) Number of children under five (0-59 months) reached by USG-supported nutrition programs; (2) Number of children under two (0-23 months) reached with community-level nutrition interventions through USG-supported programs.

58. Number of people that accessed NACS and categorization HMIS District

59. Prevalence of exclusive breastfeeding of children under six months of age

This indicator measures the percent of children 0-5 months of age who were exclusively breastfed during the day preceding the survey. Exclusive breastfeeding means that the infant received breast milk (including milk expressed or from a wet nurse) and may have received ORS, vitamins, minerals and/or medicines, but did not receive any other food or liquid, including water.

The numerator for this indicator is the sample-weighted number of children 0-5 months in the sample exclusively breastfed on the day and night preceding the survey. The denominator is the sample-weighted number of children 0-5 months in the sample with exclusive breastfeeding data.

Numerator: Number of children under 6 months of age who received only breast milk since birth.

Denominator: Total number of children aged 0-5 months surveyed.

For detailed guidance on how to collect and tabulate this indicator, refer to the WHO document: Indicators for assessing infant and young child feeding practices, Part 2, Measurement, available at http://whqlibdoc.who.int/publications/2010/9789241599290_eng.pdf

LQAS District

WASH

60. Percentage of households with soap and water (or appropriate hand-washing technology) at a handwashing station commonly used by family members

A handwashing station is a location where family members go to wash their hands. In some instances, these are fixed locations where handwashing devices are built in and are permanently placed. But they may also be movable devices that may be placed in a convenient spot for family members to use. The measurement takes place via observation by an enumerator during the household visit. The enumerator must see the soap and water (or appropriate technology) at this station. The soap may be in bar, powder, or liquid form. Shampoo will be considered liquid soap. The

LQAS Technology type (CT+, Filter+, SODIS+, BOIL+);

Residence (Rural, Urban);

Numerator, Denominator http://whqlibdoc.who.int/publications/2010/9789241599290_eng.pdf cleansing product must be at the handwashing station or reachable by hand.

A “commonly used” handwashing station, including water and soap, is one that can be readily observed by the enumerator during the household visit, and where study participants indicate that family members generally wash their hands.

Numerator: Number of households where both water and soap (or appropriate hand-washing technology) are found at the commonly used handwashing station.

Denominator: Total number of households.

Limitations: The measurement of handwashing is difficult and should preferably be conducted by objective measures that do not rely on self-reports. The presence of a handwashing station does not guarantee use.

However, this indicator has been shown to be linked with actual handwashing behavior and as such, is a useful.

61. Percentage of households in target areas practicing correct use of recommended household water treatment technologies

Households will be counted for this indicator if they are correctly practicing at least one form of evidence-based household water treatment (HWT).

HWT is also known as point of use, or POU, treatment, and comprises all methods with a peer-reviewed evidence base shown to improve the microbiological quality of the water to WHO standards of <1 CFU fecal coliforms/100 ml sample.

Specific HWT technologies that are considered for this indicator include:

- Chlorination (chemical disinfection)

- Flocculant/Disinfectant (physio-chemical disinfection)

- Filtration (physical removal)

- Solar disinfection (UV/heat disinfection)

- Boiling (disinfection via heat).

Limitations: HWT is not universally effectively against all classes of waterborne pathogens (e.g. free chlorination is ineffective against Cryptosporidium), and requires substantial education and behavior change to ensure correct and consistent use.

LQAS Technology type (CT+, Filter+, SODIS+, BOIL+);

Residence (Rural, Urban);

Numerator, Denominator

62. Percent of USAID-supported health facilities conducting hygiene audits and action planning

IP reports District

Tuberculosis

63. TB Case Detection Rate Case notification rate in new sputum smear positive pulmonary TB cases reported by DOTS programs in a specified geographic area.

Numerator: Number of new sputum smear positive pulmonary TB cases reported in the past year.

Denominator: Total population in the specified geographic area (x 100,000).

NTLP

Database/HMIS

District

64. TB Case Notification Case notification rate is all forms of TB cases reported by DOTS programs in a specified geographic area.

Numerator: Number of TB cases reported in the past year.

NTLP

Database/HMIS

District

Denominator: Total population in the specified geographic area (x 100,000).

65. TB Treatment Success Rate Percentage of registered new smear positive TB patients that completed treatment cured under DOTS programs.

Numerator: Number of TB patients registered in a specified time period that cured or completed treatment.

Denominator: Total number of new smear positive TB cases registered in the same specified time period.

NTLP

Database/HMIS

District

66. TB Cure Rate Numerator: Number of TB patients registered in a specified time period that cured Denominator: Total number of new smear positive TB cases registered in the same specified time period.

NTLP

Database/HMIS

District