1. SRH-HIV LINKAGES INDEX
Construction, explanation, issues, concerns

2. SRH-HIV LINKAGES INDEX
OVERVIEW
WHAT IS A COMPOSITE MEASURE?; PROS AND CONS
SRH-HIV CONCEPTUAL FRAMEWORK - LINKAGES
INDICATORS
DATA AVAILABILITY
WEIGHTING
METHODOLOGY REFINEMENT
SPREADSHEET & APPENDIX OVERVIEW

3. OVERVIEW SRH-HIV LINKAGES INDEX
3 domains (POLICY / SYSTEMS / SERVICES)
29 indicators, 58 total data points per country
60 Countries included in first version of the index
Key conceptual issue is INDEX PURPOSE (What is the index for? Comparing countries against each other or progress towards a goal?)
Key functional issue was DATA AVAILABILITY (what indicators have useful data? For what years?)

4. What is a COMPOSITE measure?
“A simplistic presentation and comparison of performance in a given area to be used as a starting point for future analysis.”
- OECD Handbook
The HDI (Human Development Index) (UNDP)
The MPI – Multidimensional Poverty Index (Oxford)
The CPI – Corruption Perceptions Index (Transparency International)
The GPI – Global Peace Index (Institute for Economics and Peace)

5. Pros and cons of composite measures
Summarize complex, multidimensional issues;
Facilitate comparisons based on the “big picture” instead of many separate indicators;
Be a monitoring and evaluation tool, promote accountability, drive attention;
Attract public interest, support policy-makers, data-advocacy, start a discussion;
Generate data and provide an analytical basis for future research
“Composite indices derived from development-data mashups are often trying to attach a number to an important, but unobserved, concept, for which prevailing theories and measurement practices offer little guidance.”
- Martin Ravallion, World Bank
Pros:
Summarize complex, multidimensional issues;
Facilitate comparisons based on the “big picture” instead of many separate indicators;
Be a monitoring and evaluation tool, promote accountability
Attract public interest, support policy-makers, data-advocacy, start a discussion
Cons:
May invite simplistic policy conclusions
Can be misleading if poorly constructed
May reflect incorrect subjective choices

6. SRH-HIV Linkages – conceptual framework

7. Domain 1 = 11 Indicators Domain 2 = 7 Indicators Domain 3 = 11 Indicators
SUBDOMAIN
INDICATOR
SOURCE
DOMAIN 1 - POLICY Enabling Environment for a Linked SRH and HIV Response
Strategy and Policy
National HIV Strategy - SRH Linkages
AIDSTAR ONE, UNAIDS
IEP & IPPF Coding
National Reproductive Health/Maternal Health Strategy - SRH Linkages
TBC
SRH and HIV Integration: Policy or Strategy
Legal
Legal Situation: People Living with HIV
UNAIDS Law Data
Legal Situation: Other Key Populations
Age of Consent (Marriage)
US State Department, Interpol, IEP Analysis
Stigma and Discrimination
Stigma
Stigma Index, IEP & IPPF Coding
Discrimination
UNAIDS GARPR
Gender Based Violence and Coercion
Intimate Partner Violence
Sexual Violence Programmes and Laws
Global Status Report on Violence Prevention, 2014
Agency & Social Justice
Stigma Index
DOMAIN 2 - SYSTEMS Health systems which support SRH and HIV integration
Human Resources
Physicians per 1,000 people
World Health Organization
Nurses and Midwives per 100,000 people
SRH AND HIV Commodity Stock-Outs
Reproductive Health Commodity Stock-Outs
HIV Commodity Stock-Outs
World Health Organisation
M&E/Health Information
Health System Capacity
World Bank, WDI
Health Service Coverage/Access
Access to Health Services
Family Planning Sites
DOMAIN 3 -SERVICES Integrated SRH and HIV Service Provision and Utilisation
Service Provision
Integrated HIV Health Services
UNAIDS
Service Uptake
Pregnant Women: Knowledge of HIV
Pregnant Women: Screened for Syphillis
UNAIDS,DHS
HIV Positive Pregnant Women: Receive ARV
MTCT of HIV (modelled)
Unmet Need
Unmet Need for Family Planning
Unmet Need for ART Coverage
UNAIDS, IEP Calculations
Key Populations Access to SRH and HIV Services
Sex Workers
UNAIDS, GARPR
Men who Have Sex with Men
People who Inject Drugs
Dual Protection
Condom Use: Multiple Partners

8. DATA AVAILABILITY
Data was not available for 47.5% of indicator datapoints (although some will be added soon)
Of the data that is available, the majority is from 2010 or later
Median country coverage is 55%
Domain 2 has the most missing data

9. WEIGHTING THE INDEX Domain 1: 25% Domain 2: 25% Domain 3: 50%
Indicators are equally weighted within each domain
ISSUES: Fewer indicators in domain 2, as a result domain 2 indicators are worth proportionately more of the index
Domain 2 indicators are also the least conceptually sound

10. METHODOLOGY REFINEMENT
BANDING
Should the index be absolute, relative, or normative?
YEAR CUTOFF
How new should the data be? Should it vary by indicator?
DATA CUTOFF
What should be the minimum percentage of data covered to be included in the index?
SENSE CHECK
Does the index make sense? Are the results counterintuitive?

11. SPREADSHEET AND APPENDIX OVERVIEW