Monitoring, Evaluation, and Reporting Indicator Reference ...

1 1 MER (Version ) September 2021 Monitoring, Evaluation, and Reporting Indicator Reference Guide 2 THIS PAGE IS INTENTIONALLY LEFT BLANK. OVERVIEW 3 Table of Contents Table of Contents .. 3 Tables & Figures .. 5 Abbreviations .. 6 Acknowledgments .. 8 Overview .. 9 Person-Centered Monitoring .. 11 MER Reporting Requirements .. 13 Disaggregated 13 Location: .. 13 Age:.. 13 Sex: .. 14 Key Populations: .. 14 Priority Populations: .. 14 Types of PEPFAR Support: .. 14 Disaggregation Types: .. 14 Required Disaggregations: .. 14 Conditional Disaggregations: .. 14 Optional Disaggregations: .. 14 PEPFAR Support to Communities and Sites .. 14 DSD: .. 15 TA-SDI: .. 15 Support in Centrally Supported Areas: .. 15 Age Disaggregations: .. 16 Host Country National Program.

2 17 Host Country Targets .. 17 Host Country Results .. 17 Reporting MER Results in DATIM .. 18 Routine Data Cleaning & Completeness Checks .. 19 Data Entry and Review Process Overview .. 19 Implementing Partner Review Process .. 20 Agency Review Process .. 20 Interagency Review Process .. 20 Data Review Completeness Tools .. 20 MER Data Cleaning and Completeness Review Favorites .. 20 Auto-Population of HTS_TST Modalities: .. 22 Auto-Sum Numerators and Denominators: .. 22 MER Indicator Narratives .. 23 Guiding Narrative Questions .. 23 Implementing Mechanism (IM) Indicator Narratives .. 23 USG Technical Area Indicator Narratives .. 23 Host Country Indicator Targets & Results Narratives .. 23 Justification Narrative .. 24 Source Narrative .. 24 Initiative-Specific Narratives.

3 24 Calculated Indicators .. 24 Data Quality .. 25 Standardized Health Data Exchanges & Surveillance Systems .. 26 Commitment to data transparency .. 26 Key Updates and Changes: MER to MER .. 27 Indicator Trainings: .. 27 New Indicators: .. 27 4 New Disaggregations: .. 27 Changes in Reporting Frequency: .. 28 Retired Indicators .. 28 Indicator Definition Clarifications .. 28 How to read a PEPFAR Indicator Reference sheet .. 34 PREVENTION & SUPPORT INDICATORS .. 35 AGYW_PREV .. 36 FPINT_SITE .. 45 GEND_GBV .. 49 KP_MAT .. 52 KP_PREV .. 54 OVC_SERV .. 58 PP_PREV .. 67 PrEP_CT .. 72 PrEP_NEW .. 75 TB_PREV .. 78 VMMC_CIRC .. 82 TESTING INDICATORS .. 84 CXCA_SCRN (including CXCA_SCRN_POS) .. 85 HTS_INDEX .. 89 HTS_RECENT .. 96 HTS_SELF .. 105 HTS_TST (including HTS_TST_POS).

4 109 OVC_HIVSTAT .. 119 PMTCT_EID .. 126 PMTCT_FO .. 129 PMTCT_HEI_POS .. 132 PMTCT_STAT (including PMTCT_STAT_POS) .. 136 TB_STAT (including TB_STAT_POS) .. 139 TREATMENT INDICATORS .. 141 CXCA_TX .. 142 PMTCT_ART .. 145 TB_ART .. 147 TX_CURR .. 149 153 TX_NEW .. 159 TX_RTT .. 162 TX_TB .. 166 VIRAL SUPPRESSION INDICATORS .. 169 TX_PVLS .. 170 HEALTH SYSTEMS INDICATORS .. 175 EMR_SITE .. 176 HRH_PRE .. 179 LAB_PTCQI .. 182 SC_ARVDISP .. 190 SC_CURR .. 194 HOST COUNTRY INDICATORS .. 198 DIAGNOSED_NAT .. 199 TX_CURR_NAT .. 201 OVERVIEW 5 VL_SUPPRESSION_NAT .. 203 PMTCT_STAT_NAT .. 205 PMTCT_ART_NAT .. 207 VMMC_CIRC_NAT .. 208 VMMC_TOTALCIRC_NAT .. 209 HRH_STAFF_NAT .. 210 KP_MAT_NAT .. 212 MONITORING SPECIAL INITIATIVES .. 213 DREAMS .. 214 Faith and Community Initiative.

5 217 MenStar .. 220 Key Populations Investment Fund (KPIF) .. 222 Cervical Cancer Screening and Treatment .. 223 224 Appendix A: Key Populations Classification Document .. 225 Appendix B: Calculated Indicators Reference Table .. 226 Appendix C: DQA of National and Partner HIV Treatment and Patient Monitoring Systems .. 238 Appendix D: Site and SNU Attributes and Epidemiologic Estimates .. 248 Appendix E: Illustrative eligible services for Active OVC beneficiaries (children and caregivers) .. 250 Appendix F: Global OVC Graduation Benchmarks Matrix .. 253 Appendix G: Central Support .. 255 Appendix H: Monitoring Mortality Among PLHIV .. 258 Appendix I: Proposed HIV-Specific Short Cause of Death List .. 260 Appendix J: Visual Representation of TX_CURR, TX_ML, TX_NEW, and TX_RTT.

6 261 Tables & Figures Figure 1: PEPFAR Monitoring: Getting from Process to Impact .. 9 Figure 2: Patient-Centered Monitoring in PEPFAR .. 11 Figure 3a: Potential treatment client loss in one PEPFAR program in FY21 Q2 .. 12 Figure 3b: Detailed breakdown of TX_ML data ..12 Figure 4: Indicator Reporting frequency and the PEPFAR fiscal year .. 13 Table 1: Evolution of PEPFAR Finer Age Bands for Results Reporting .. 16 Table 2: Host Country indicators by Reporting level, targets, and results .. 18 Figure 5. MER data flow from the site to country level .. 18 Figure 6. MER data entry and review process .. 19 Figure 7. MER result and target review favorites in DATIM .. 21 Figure 8. Naming convention for MER result and target review favorites in DATIM .. 21 Figure 9: Auto-Population of HTS_TST from Associated Indicators.

7 22 Figure 10: Calculated Indicator examples .. 25 Table 3: Indicator Summary Table .. 29 Table 4: Frequency of Reporting Table .. 32 Figure 11: PEPFAR MER Indicators Infographic .. 33 6 Abbreviations ART antiretroviral therapy ARV antiretroviral BF breastfeeding CBS case-based surveillance COD cause of death COP PEPFAR Country Operational Plan CQI continuous quality improvement CRVS civil registration and vital statistics CXCA cervical cancer DATIM Data for Accountability, Transparency, and Impact DQA data quality assessment DREAMS Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe DSD direct service delivery EID early infant diagnosis EMR electronic medical record FBO faith-based organization FCI Faith and Community Initiative FSW female sex worker FY fiscal year GAM UNAIDS Global AIDS Monitoring GBV gender-based violence HCW health care worker HEI HIV-exposed infant HIVST HIV self-testing HRH human resources for health HTS HIV testing services IIT interruption in treatment IM implementing mechanism IP implementing partner L&D labor and delivery LTFU lost to follow-up KP key populations KPIF Key Populations Investment Fund MAT medication-assisted treatment MER monitoring, evaluation.

8 And Reporting indicators MMD multi-month dispensing MOH Ministry of Health MSM men who have sex with men OVERVIEW 7 OVC orphans and vulnerable children PEP post-exposure prophylaxis PEPFAR United States President s Emergency Plan for AIDS Relief PHIA Population-Based HIV Impact Assessment PITC provider-initiated testing and counseling PLHIV people living with HIV PMTCT prevention of mother-to-child transmission POART PEPFAR Oversight and Accountability Response Team POCT point-of-care testing PP priority populations PrEP pre-exposure prophylaxis PT proficiency testing PVLS patient viral load suppression PWID people who inject drugs SID sustainability index SI strategic information SIMS site improvement through monitoring systems STI sexually transmitted infection TA-SDI technical assistance for service delivery improvement TB tuberculosis TG transgender people TX treatment UNAIDS Joint United Nations Programme on HIV/AIDS USG United States Government VL viral load VLS viral load suppression VMMC voluntary medical male circumcision WHO World Health Organization 8 Acknowledgments MER Indicator Refresh Headquarters Team: Pooja Vinayak (S/GAC), Maria Au (USAID), Jordana De Leon (Peace Corps), Salem Gugsa (HRSA), Heather Iufer (DOD), Brandon Khuu (DOD), Michelle Selim (S/GAC), Nadia Solehdin (CDC) MER Indicator Refresh Field Committee: Abdulmalik Abubakar (USAID: Malawi), Sisay Alemayehu (CDC: Ethiopia), Patrick Amanzi (USAID: Zambia), Eddie Kavalo (Peace Corps: Malawi), Todd Koppenhaver (USAID.)

9 Uganda), Samuel Kudhlande (CDC: Eswatini), Mutsa Mhangara (USAID: Zimbabwe), Ghislain Mumbari (DOD: Cameroon), Mduduzi Ndlovu (CDC: South Africa), Phuong Nguyen (CDC: Vietnam), Touma Ng'wanakilala (Peace Corps: Tanzania), Ifeanyi Okoye (DOD: Nigeria), Jose Manuel Rodas Hernandez (CDC: Western Hemisphere) Indicator Leads and Training Content Development Team: George Alemnji, Teeb Al-Samarrai, Gretchen Bachman, Telile Bayissa, Stephanie Behel, Caroline Cooney, Michelle Chevalier, Jennifer Cole, Marie Davis, Meaghan Douglas, Erin Eckstein, Grace Ferguson, Rena Fukunaga, Katy Godfrey, Parviez Hosseini, Sara Klucking, Maryanne Ombija, Amber Prainito, Maddy Schneider, Paige Schoenberg, Michelle Selim, Hilary Wolf, Michelle Zavila, Nicole Zender Headquarters Subject Matter Experts: Thank you to the many SMEs that contributed their time and expertise into developing and refining the MER indicators.

10 OVERVIEW 9 Overview PEPFAR's focus on optimizing impact is a driving force behind global efforts to reach HIV epidemic control, defined as the point at which the total number of new HIV infections falls below the total number of deaths from all causes among HIV-infected individuals. PEPFAR is partnering with the international community to accelerate towards the UNAIDS 95-95-95 global goals: 95 percent of people living with HIV know their HIV status, 95 percent of people who know their HIV status are accessing treatment, and 95 percent of people on treatment have suppressed viral loads. Progress towards epidemic control will be successfully measured, in part, through an effective strategic information framework that not only monitors program outputs, but also key outcomes and programmatic impact.