Developing a system to monitor family planning and HIV service integration: Results from a pilot test of indicators

Abstract

Objectives To determine the feasibility of collecting data to calculate six indicators of family planning (FP) and HIV integration using existing health information systems (HIS); obtain information to refine indicators; and identify changes needed in existing HIS to calculate indicators. Design Data abstraction from HIS in a purposive sample of 39 health facilities in Ethiopia, Rwanda, Tanzania and Uganda to analyse data availability and quality undertaken between November 2010 and March 2011. Methods Teams reviewed patient record cards, registers, monthly and quarterly reports for the most recent complete month. Teams recorded all possible sources for each data element, indicated whether data are collated monthly, and whether disaggregation by age, sex and originating service was possible. Results With the exception of Uganda, all countries were able to report the proportion of service delivery points offering integrated services. Ethiopia was able to calculate the indicator for fixed sites but not for homebased care services. In most cases we were able to calculate the proportion of HIV clients receiving FP services or referral, and the proportion of FP clients receiving an HIV test or referral. It is feasible to collect data for these indicators under current circumstances in some countries. Conclusions Several actions are proposed for national health systems, including adopting a system of unique client identifiers. Age group reporting bands should be aligned across services. More accurate counts of daily and active client loads are needed to provide programme managers with information to inform programme monitoring.