1. Module 3: Basic analyses

2. Module 3: Learning objectives  Understand common analyses that calculate program coverage and efficiency  Calculate program coverage and retention

3. Terminology  Indicator  Program coverage  Service availability  Service utilization  Program retention

4. Indicator  Program element that needs tracking  Measures an aspect of a program’s performance  Measures changes over a period of time Number of new family planning users Number of clients currently on ART  Expressed as a number or percentage

5. Common Analyses  Program coverage  Extent to which a program reaches its intended target population, institution, or geographic area  Compare current performance to prior year/quarter  Compare performance between sites  Program retention  Extent to which the range of services are being delivered as initially intended so that client drop- outs are minimal

6. 6 Why do we need to measure coverage?  To understand program progress  To determine if the target is reached  Clients, commodities, adherence…  To determine if one target is reached more effectively than another Are there underserved areas/regions, subpopulations?

7. Program coverage  Extent to which a program reaches its intended target population, institution, or geographic area  Utilization:  Is the target population utilizing services, accessing commodities, being reached with services?  Availability:  Are the services available where there is a need?

8. Utilization calculation Percentage of the target population utilizing services # of individuals in target population using a service ------------------------------------------- x 100 # of individuals in target population

9. Utilization calculation – example  No. of persons educated as of 6/12/09 = 300  Goal for 12/31/09 = 900 300 900  You have reached 33% of your target group with education messages = 0.33 x 100 = 33%

10. Comparison of time periods  Compare percentage achieved toward target in different time periods, different sites, etc.  Rate of increase  As of January, 70 people educated; as of June, 300 people  300 - 70 = 230 increase in people educated  230/6 = 38.3 new people educated per month

11. Sought prenatal care (600) All pregnant women (2,000) PMTCT Target (1,000) Utilization = Service users Target population Counseled & Tested for HIV (500) Utilization of PMTCT Programs Utilization = 600/ 1,000 = 0.6 0.6 x 100 = 60%

12. Program coverage  Extent to which a program reaches its intended target population, institution, or geographic area  Utilization:  Is the target population utilizing services, accessing commodities, being reached with services?  Availability:  Are the services available where there is a need?

13. Availability calculation  Number of service outlets available per target population  Number of clinics with PMTCT per number of pregnant women  Expressed as a ratio

14. PMTCT clinic availability  There are 8 clinics offering PMTCT & 100,000 pregnant women in region X.  Ratio of clinics to pregnant women 8:100,000  Reduce (1:12,500) pregnant women  The standard recommendation is 1 clinic with PMTCT services per 10,000 pregnant women  Clinic availability is not reaching the target

15. Availability + Utilization = Coverage  Service availability is 1:12,500  Service availability target is 1:10,000  PMTCT service utilization is 25% off the target  What can we conclude?  Service availability and utilization are too low; the program is not meeting the needs of pregnant women.

16. 16 Program retention  Measures if the range of services are being delivered as initially intended  Determines program retention, i.e., if the project is keeping clients through entire package of services Important in clinical programs where drug adherence is an issue (TB, HIV/AIDS, immunization) and there are multiple steps (PMTCT)

17. Utilization Retention example: Immunization Enter service Polio dose 1 Polio dose 2 Polio dose 3 Completion

18. Tested for HIV (500) Sought prenatal care (600) All pregnant women (2,000 women) PMTCT Target (1,000) 40 received prophylaxis 350 received HIV- result or no result 100 received HIV+ result PMTCT Program Retention

19. Tested for HIV Sought prenatal care All pregnant women (2,000 women) 40 received prophylaxis 350 received HIV- result 100 received HIV+ result 1,000 500 PMTCT Program Retention

20. Tested for HIV (500) Sought prenatal care (600) All pregnant women (2,000 women) PMTCT Target (1,000) 40 received prophylaxis 350 received HIV- result 100 received HIV+ result PMTCT Program Retention

21. Tested for HIV (500) Sought prenatal care (600) All pregnant women (2,000 women) PMTCT Target (1,000) 40 received prophylaxis 350 received HIV- result or no result 100 received HIV+ result PMTCT Program Retention

22. Tested for HIV (500) Sought prenatal care (600) All pregnant women (2,000 women) PMTCT Target (1,000) 40 received prophylaxis 350 received HIV- result or no result 100 received HIV+ result PMTCT Program Retention

23. Key messages  Coverage – extent to which a program reaches its intended target population, institution, or geographic area  Retention – the extent to which the range of services are being delivered as initially intended with clients retained throughout the full package of services  It is important to look at both to fully understand your services