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Module 2: Basic analyses. Module 2: Learning Objectives. Identify approaches for setting targets Understand common analyses that calculate program coverage and retention Calculate program coverage and retention. Terminology. Indicator Target Program coverage Service availability - PowerPoint PPT Presentation
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Module 2:Basic analyses
Module 2: Learning Objectives
Identify approaches for setting targets
Understand common analyses that calculate program coverage and retention
Calculate program coverage and retention
Terminology
Indicator
Target
Program coverage
Service availability
Service utilization
Program retention
Indicator
Program element that needs tracking
Measures an aspect of a program’s performance
Measures changes over a period of time
• # of new family planning users
• # of clients currently on ART
Expressed as a number or percentage
Target Definition
A specified level of performance for a measure (indicator), at a predetermined point in time (i.e., achieve ‘x’ by ‘y’ date)
Overall target
Annual targets
Why Set Targets?
Targets help program staff with: Planning
– Staffing and service delivery– Commodities
Monitoring progress – Break long-term goals into manageable pieces – Check progress on indicators
Setting Reasonable Targets The range of values for a given indicator
can be from 0% to 100%. • Example: The theoretical range for the Polio
indicator is between 0% of children immunized (bad) and 100% immunized (ideal)
• Is it appropriate to set the Polio indicator target at 100% for a given program? Why/why not?
Setting Reasonable Targets
Example: In Somalia, the national CPR from 2007 to 2009 was15%. The following year, a national target was set for 70%.
Is it appropriate to set the CPR target for Somalia at 70%? Why/why not?
Overall Target Setting Approaches There are three approaches to set a target :
Established long-term goals by contacting that national program
Past performance (of your program, increasing by no more than 10%)
Local high performer (a stellar program nearby)
Consider the number of clients your program can realistically expect to serve during a given period of time
Annual Target Setting
Determine the increase your program needs to gain to reach your overall target
Divide that number by the number of years in which you would like to achieve the target
Add the number to your baseline indicator for each year
Considerations for Target Setting
Ensure you have an agreed-upon and realistic definition of target population
Set a realistic target to achieve in the long term and short term
Importance of Defining the Target Population: Case Example
Target was 372 children to be immunized
Actual was 488 children immunized
To calculate the % target achieved, use (Actual/Target) * 100
488/372 = 1.31*100 = 131%
How could the clinic have surpassed its target by so much?
Implications of Incorrect Target Setting: Case Example
You don’t really know to what extent you’re fully immunizing the children in your setting
If your program purchases commodities (e.g., vaccines) based on the target set, supply could run out
If you set your target too low, you may not have enough vaccines, leading to disease outbreaks
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 is being delivered as initially intended so that client drop-outs are minimal
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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 area/regions, subpopulations?
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?
Utilization calculation
Percentage of the target population utilizing services
# of individuals in target population
using a service
------------------------------------------- X 100
# of individuals in target population
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%
Comparison of time periods
Compare percentage achieved toward target for different time periods, different sites, etc.
Rate of increase
As of January, 70 people educated; by June, 300 people
300 – 70 = 230 increase in people educated
230/6 = 38.3 new people educated per month over the 6 months
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%
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?
Availability calculation
Number of service outlets available per target population
# of clinics with PMTCT per # of pregnant women
Expressed as a ratio
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 to (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
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.
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Program retention
Measures if the range of services are being delivered as initially intended
Determines program retention, i.e., is the project 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)
Utilization
Retention example: Immunization
Completion
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
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
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
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
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
Key messages
Target Setting – A specified level of performance for a measure (indicator) at a predetermined point in time. Both overall and annual targets are set
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