CHAPTER 6: HIV/AIDS INDICATORS’ REFERENCE PAGES (cont.)

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HIV/AIDS Care, Support and Treatment

Socioeconomic and material support

Clinical care including ARV therapy and TB treatment

Orphans and vulnerable children (OVC)

Legal and human rights

Mainstreaming

National Commitment and Action

HIV/AIDS Care, Support and Treatment

Socioeconomic and material support

CST1: External support for chronically ill persons

Definition

Percentage of people aged 15-59 who has been ill for 3 or more months in the last 12 months and whose household received free basic external support in caring for the chronically ill person (disaggregated by age, sex, region and source, type and level of free support)

Purpose

To assess the extent of free support services to households with chronically ill persons

Measurement tool

Population-based survey

Frequency

Every 5 years

Responsible body

MoLSA/HAPCO

Method of measurement

Respondents in a population-based survey are asked whether anyone in their household has been too ill to work or perform their normal duties for three consecutive months or more out of the previous 12 months.

The question should include people who have died within the past 12 months and who were incapacitated for at least three months before their death.

Households that report chronically ill persons for 3 or more months are asked the age(s) of that/those person(s), and whether they received external support.

External support refers to help coming from sources other than friends, family, or neighbors unless they are working for a community-based group or organization.

Numerator: Number of persons 15-59 who have been ill for 3 or more months in the last 12 months and whose household received free external support including all the three types:

1. Medical support at least once a month while ill

2. Emotional/psychological support in the last 30 days

3. Social support (including material support) in the last 30 days

Persons who were ill for 3 or more months before death in the past 12 months should be included

Denominator: All persons 15-59 who were ill for 3 or more months during the past 12 months, including those ill for 3 or more months before death

Note:

This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003

Remark

UNAIDS and WHO indicator

CST2: Home-based programs

Definition

Number of people aged 15-59 who has received help from home-based program in the last 12 months (disaggregated age, sex, region and type and level of support)

Purpose

To assess availability and coverage of home-based care programs for people infected and affected by HIV/AIDS

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

All stakeholders who have home-based programs are expected to report to HAPCO on the number of people aged 15-59 infected or affected by HIV/AIDS who received any type of support such as medical, emotional/psychological, and/or economic (including material support)

Remark

Clinical care including ARV therapy and TB treatment

CST3: Antiretroviral combination therapy

Definition

Percentage of people with advanced HIV infection receiving ARV combination therapy (disaggregated by age, sex, region, and urban/rural)

Purpose

To assess progress in providing antiretroviral combination therapy to all people with advanced HIV infection

Measurement tool

Program monitoring and estimate

Frequency

Annual

Responsible body

MoH/(DACA)/HAPCO

Method of measurement

Method of measurement

Numerator: Number of people (i.e., adults and children) with
advanced HIV infection who receive antiretroviral combination therapy according to the nationally approved treatment protocol

A: Number of people with advanced HIV infection receiving treatment at start of year

+

B: Number of people with advanced HIV infection who commenced treatment in the last 12 months

_

C: Number of people with advanced HIV infection for whom treatment was terminated in the last 12 months (including those who died)

Denominator: Number of people with advanced HIV infection

The denominator is estimated to be 15% of the total number of people currently infected (based on the most recent national Sentinel Surveillance data).

Note:

Private sector antiretroviral provision should be included in the calculation of the indicator wherever possible and the extent of such provision should be recorded separately

Remark

UNGASS and WHO indicator

CST4: Health facilities providing or referring for care and support services

Definition
Percentage of health facilities that either provide comprehensive care and support services onsite for people living with HIV/AIDS or through an effective referral system (disaggregated by region)

Purpose

To assess progress on availability of comprehensive care and support services for PLWHA

Measurement tool

Health facility survey

Frequency

Every 3 years

Responsible body

MoH/HAPCO

Method of measurement

Method of measurement

Health facilities are randomly selected and from each facility a health provider is asked whether the facility provides or effectively refers for essential comprehensive care and support services (listed 1-4 below)

Essential comprehensive care and support services include the following:

1. Medical services: outpatient or inpatient treatment of OIs and other HIV-related conditions; preventive therapies for OIs and/or TB, symptomatic palliative care, HIV testing and pre and post-test counseling; and ART

2. Psychological services: Emotional support and follow-up counseling; PLWHA support groups and/or post-test clubs; spiritual support

3. Social/legal support: Community and home-based organizations/faith-based organizations or other organizations that offer material, food, financial, or legal support for PLWHA and their families.

4. Support for OVC: Community-based organizations/faith-based organizations or other organizations that strengthen care and support interventions for orphans and vulnerable children affected by HIV/AIDS.

Effective referral is defined as follows:

a. Whether the facility has a referral directory or list of services in that area that include name and contact information

b. If there is a referral form the health provider can name a location where clients are referred for services

c. If there is a register where referrals are recorded

Numerator: Number of health facilities either providing or
effectively referring for essential comprehensive
care and support services

Denominator: Total number of health facilities surveyed

Remark

WHO indicator

CST5: Health facilities that can provide basic HIV test and clinical management

Definition

Percentage of health facilities that have the capacity and conditions to provide basic level HIV testing and HIV/AIDS clinical management (disaggregated by region)

Purpose

To assess progress on availability of basic level HIV testing and HIV/AIDS clinical management services

Measurement tool

Health facility survey

Frequency

Every 3 years

Responsible body

MoH/HAPCO

Method of measurement

Health facilities are randomly selected and assessed whether there is (are):

a. A system for testing and providing results for HIV/AIDS

b. Systems and qualified staff for pre and post-test counseling

c. Specific medical services relevant to HIV/AIDS, and resources and supplies for providing these services

d. Elements for prevention of nosocomial infections

e. Trained staff and resources for providing basic interventions for prevention and medical treatments for HIV-infected persons

Note: Details of each of these elements (a-e) is included
in Annex3

Numerators:

Number of health facilities where individual items from each component exists

Number of health facilities where a, b, c, d and e exist

Number of health facilities where a, b, c, d or e exist

Denominators:

Total number of health facilities surveyed

Total number of health facilities where HIV/AIDS services in each domain are offered or relevant

Note:

This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003

Remark

WHO indicator

CST6: Health facilities that can provide advanced level care and support services for PLWHA

Definition

Percentage of health facilities that have the capacity and conditions to provide advanced level care and support services for PLWHA, including provision and monitoring of ART (disaggregated by region)

Purpose

To assess progress on availability of advanced level care and support services for PLWHA

Measurement tool

Health facility survey

Frequency

Every 3 years

Responsible body

MoH/HAPCO

Method of measurement

Health facilities are randomly selected and assessed whether there is (are):

a. Systems and items to support management of OIs and provision of palliative care (symptomatic treatment) for advanced care of PLWHA

b. Systems and items to support advanced services to care for HIV-infected clients

c. Systems and items to support ART services

d. Conditions to provide advanced inpatient care for ill clients with HIV/AIDS

e. Conditions to support home care services

f. Post-exposure prophylaxis

Note: Details of each of these elements (a - f) is included in
Annex 4

Numerators:

Number of health facilities where individual items from each component exists

Number of health facilities where a, b, c, d, e and f exist

Number of health facilities where a, b, c, d, e or f exist

Denominators:

Total number of health facilities surveyed

Total number of health facilities where HIV/AIDS services in each domain are offered or relevant

Remark

WHO indicator

CST7: Availability of laboratories to monitor ART

Definition
Percentage of designated laboratories with the capacity to monitor ART according to national guidelines

Purpose

To assess availability and ability of laboratories to carry out minimal as well as more advanced HIV testing requirements in order to assure appropriate use of ART

Measurement tool

Reports from nationally designated labs for monitoring ART

Frequency

Annual

Responsible body

MoH/EHNRI/HAPCO

Method of measurement

In order to scale up ARV use in resource limited settings, WHO prioritize currently available testing into 4 categories:

1. Absolute minimum tests before starting ART: HIV antibody test, hemoglobin or hematocrit level

2. Basic tests: white blood cell count and differential, serum alanine or asparatate aminotransferase level, serum creatinine, blood urea nitrogen, serum glucose, and pregnancy test.

3. Desirable tests: bilirubine, amylase, serum lipid and CD4 count

4. Optional tests: viral load

Numerators:

Number of designated laboratories that meet minimum testing requirement for categories 1 and 2 (above)

Number of designated laboratories that meet minimum testing requirement for categories 1, 2 and 3 (above)

Number of designated laboratories that meet minimum testing requirement for all four categories (above)

Denominator:

Total number of designated laboratories

Remark

WHO indicator

Orphans and vulnerable children (OVC)

CST8: External support for households with OVCs

Definition

Percentage of households caring for orphans and vulnerable children who received free external support in the last 12 months (disaggregated by age and sex of OVC, region and source, type and level of free support)

Purpose

To assess free external supports given to households with orphans and vulnerable children

Measurement tool

Population-based survey

Frequency

Every 5 years

Responsible body

MoLSA/HAPCO

Method of measurement

Respondents in a population-based survey are asked whether their household is currently caring for any orphan or vulnerable children defined here as children under the age of 18 who have at least one dead parent (mother or father) or a chronically ill parent who was very sick for 3 or more months during the last 12 months.

If the household is currently caring for OVCs, the respondent is asked whether they received free external support, which refers to help coming from sources other than friends, family, or neighbors unless they are working for a community-based group or organization.

Numerator: Number of households with OVCs that received
(free):

1. Medical support within the last 12 months

2. Emotional/psychological support within the last 3 months

3. School-related assistance within the past 12 months

4. Other social support (including material support) within the last 3 months

5. All four types of support

Denominator: Total number of households with OVCs

Note:

This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003

Remark

WHO and UNAIDS indicator

CST9: External support to OVCs

Definition

Number of orphans and vulnerable children who received free external support in the last 12 months (disaggregated by age and sex of OVC, region and type and level of free support)

Purpose

To assess availability and coverage of free socioeconomic and material support to orphans and vulnerable children

Measurement tool

Program report

Frequency

Annual

Responsible body

HAPCO

Method of measurement

Orphan or vulnerable children defined here as children under the age of 18 who have at least one dead parent (mother or father) or a chronically ill parent who was very sick for 3 or more months during the last 12 months

All stakeholders providing any type of free support to orphans and vulnerable children are expected to report HAPCO about the number of OVCs and type and level of support such as medical, emotional/psychological, school-related or economic (including material support)

Remark

CST10: Orphans’ school attendance

Definition

Ratio of current school attendance among orphans to that among non-orphans aged 10-14 (disaggregated by age, sex, region and urban/rural)

Purpose

To assess progress in preventing relative disadvantage in school attendance among orphans versus non-orphans

Measurement tool

Population-based survey

Frequency

Every 5 years

Responsible body

MoLSA/MoE/CSA/HAPCO

Method of measurement

Method of measurement

Ratio of the current school attendance rate of children aged 10-14 both of whose biological parents have died to the current school attendance of children aged 10-14 whose parents are both still alive and who currently live with at least one biological parent.

Orphans’ school attendance (1):

Numerator: Number of children who have lost both parents
and are still in school

Denominator: Number of children who have lost both parents

Non-orphans’ school attendance (2):

Numerator: Number of children, both of whose parents are
still alive, who live with at least one parent and
who are still in school

Denominator: Number of children whose parents are both still
alive and who live with at least one parent

Calculation of the indicator (ratio): (1) to (2)

Note:

Indicator scores required for boys and girls separately. Where possible, the indicator should also be calculated by single years of age

The minimum number of orphaned 10-14-year-old children needed to calculate this indicator is 50.

Remark

UNGASS indicator

Legal and human rights

CST12: PLWHA’s knowledge of rights and obligations

Definition

Percentage of PLWHA who correctly know their rights and obligations under the law (disaggregated by age, sex and region)

Purpose

To assess progress made in increasing knowledge about rights and obligations of PLWHA

Measurement tool

Special study

Frequency

Every 3 years

Responsible body

HAPCO/MoJ/HAPCO

Method of measurement

PLWHA will be asked on key questions regarding their rights and obligations (the specific questions on rights and obligations of PLWHA will be constructed in consultation with MoJ and relevant individuals)

Numerator: Number of PLWHA who gave the correct
answers to all questions

Denominator: Number of PLWHA who gave answers
(including "do not know") to all questions

Note:

Indicator score should also be reported for each question

Remark

CST13: HIV/AIDS related court cases timely settled

Definition

Percentage of HIV/AIDS related court cases in the last 12 months that were settled in the same period

Purpose

To assess progress made in timely settling HIV/AIDS related court cases

Measurement tool

Special study

Frequency

Every 3 years

Responsible body

MoJ/HAPCO

Method of measurement

Courts and cases will be randomly selected from all regions and assessed on timely settling HIV/AIDS related cases

Numerator: Number of HIV/AIDS related court cases in the
last 12 months that were settled in the same
period

Denominator: Number of HIV/AIDS related court cases in the
last 12 months

Remark

Mainstreaming

PS1: Workplace HIV/AIDS control

Definition

Percentage of large enterprises/companies that have HIV/AIDS workplace policies and programs

Purpose

To assess progress in implementing workplace policies and programs to combat HIV/AIDS

Measurement tool

Work place survey

Frequency

Every 2 years

Responsible body

HAPCO/CETU/EEF

Method of measurement

Survey of the 30 largest employers (12 private and 18 public) will be conducted. Private sector employers are selected on the basis of the size of the labour force. Public sector employers will include, among others, the ministries of transport, labour, tourism, education, defense, agriculture and health. Employers are asked to state whether they are currently implementing personnel policies and procedures that cover, as minimum, all of the following aspect(s):

1. Prevention of stigmatization and discrimination on the basis of HIV infection status in: (a) staff recruitment and promotion; and (b) employment, sickness and termination benefits

2. Workplace-based HIV/AIDS prevention, control and care programs that cover: (a) the basic facts on HIV/AIDS;
(b) specific work-related HIV transmission hazards and safeguards; (c) condom promotion; (d) VCT; (e) STI diagnosis and treatment; and (f) provision of HIV/AIDS-related drugs

Numerator: Number of employers with HIV/AIDS policies
and regulations that meet all of the above criteria

Denominator: Number of employers surveyed (30)

Remark

UNGASS indicator adapted to National need

PS2: HIV/AIDS activities integrated into sector plans

Definition

Percentage of government offices that have integrated specific HIV/AIDS activities into their sector plan in the last 12 months

Purpose

To assess progress in integrating HIV/AIDS activities into the regular sector plan

Measurement tool

Survey of government agencies

Frequency

Every 2 years

Responsible body

HAPCO

Method of measurement

15-20 government agencies including ministries, authorities, and commissions are randomly selected and assessed whether HIV/AIDS activities are included into their annual plans. Existence of HIV/AIDS related activities and allocated resources (finance, personnel and time) are checked.

Numerator: Number of government offices who integrated
HIV/AIDS activities into sector plan

Denominator: Number of government offices surveyed

Remark

a. Surveillance and Research

PS3: Researches carried out

Definition

Number of national level HIV/AIDS related researches carried out in the last 12 months

Purpose

To assess the focus given and capacity to conduct HIV/AIDS related research activities

Measurement tool

Program reports/Review of research papers

Frequency

Annual

Responsible body

HAPCO

Method of measurement

Method of measurement

The indicator will be measured by counting the number researches conducted at national level in the following areas

Impact assessments on Education, Labor, Health and Agriculture

Operational Research on ART (e.g. compliance, resistance), PEP and ABE

Major nationwide HIV/AIDS surveys (e.g. DHS, BSS)

Note:

A database system will be established to track all HIV/AIDS related researches conducted in the country. The database will also track important researches and evaluation results conducted at national level, in specific locations of the country as well as in other countries. The database system, web based, will be accessible to researchers and other users.

All partners conducting HIV/AIDS related research or evaluation of intervention programs should send a copy of the research/evaluation report(s) to HAPCO

Remark

PS4: HIV Sentinel Surveillance sites

Definition

Number of National HIV Sentinel Surveillance sites existing at the time of data collection (disaggregate by regions and urban /rural)

Purpose

To assess the geographic coverage of HIV sentinel sites

Measurement tool

Program report

Frequency

Every 2 years

Responsible body

MoH/HAPCO

Method of measurement

Count the total number of HIV sentinel sites per Region (disaggregated by urban/rural)

Remark

National Commitment and Action

PS5: Government funding for HIV/AIDS

Definition
Amount of National funds spent by Government on HIV/AIDS

Purpose

To monitor the flow of national funding for HIV/AIDS as a measure of National Government’s economic commitment to fight HIV/AIDS

Measurement tool

Document review

Frequency

Every 2 years

Responsible body

HAPCO

Method of measurement

Survey of National Government expenditure on HIV/AIDS programs. The cost of any multilateral or bilateral international donor-funded government programs should be excluded. Similarly, all local NGO programs should be excluded, except for programs (or part of programs) that are funded by the national government.

Allocated national funds comprise expenditure on the following four categories of programs, totals for each of which should be specified separately:

1. STD control activities

2. HIV prevention

3. HIV/AIDS clinical care and treatment

4. HIV/AIDS impact mitigation

Note:

It may be difficult to disaggregate Government fund by the above four categories. Even though, effort will be made to disaggregate the indicator, in the early stage of compiling the indicator lump sum will be accepted.

Remark

UNGASS indicator


CST1: External support for chronically ill persons
Definition	Percentage of people aged 15-59 who has been ill for 3 or more months in the last 12 months and whose household received free basic external support in caring for the chronically ill person (disaggregated by age, sex, region and source, type and level of free support)
Purpose	To assess the extent of free support services to households with chronically ill persons
Measurement tool	Population-based survey
Frequency	Every 5 years
Responsible body	MoLSA/HAPCO
Method of measurement	Respondents in a population-based survey are asked whether anyone in their household has been too ill to work or perform their normal duties for three consecutive months or more out of the previous 12 months. The question should include people who have died within the past 12 months and who were incapacitated for at least three months before their death. Households that report chronically ill persons for 3 or more months are asked the age(s) of that/those person(s), and whether they received external support. External support refers to help coming from sources other than friends, family, or neighbors unless they are working for a community-based group or organization. Numerator: Number of persons 15-59 who have been ill for 3 or more months in the last 12 months and whose household received free external support including all the three types: 1. Medical support at least once a month while ill 2. Emotional/psychological support in the last 30 days 3. Social support (including material support) in the last 30 days Persons who were ill for 3 or more months before death in the past 12 months should be included Denominator: All persons 15-59 who were ill for 3 or more months during the past 12 months, including those ill for 3 or more months before death Note: This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003
Remark	UNAIDS and WHO indicator


CST2: Home-based programs
Definition	Number of people aged 15-59 who has received help from home-based program in the last 12 months (disaggregated age, sex, region and type and level of support)
Purpose	To assess availability and coverage of home-based care programs for people infected and affected by HIV/AIDS
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	All stakeholders who have home-based programs are expected to report to HAPCO on the number of people aged 15-59 infected or affected by HIV/AIDS who received any type of support such as medical, emotional/psychological, and/or economic (including material support)
Remark


CST3: Antiretroviral combination therapy
Definition	Percentage of people with advanced HIV infection receiving ARV combination therapy (disaggregated by age, sex, region, and urban/rural)
Purpose	To assess progress in providing antiretroviral combination therapy to all people with advanced HIV infection
Measurement tool	Program monitoring and estimate
Frequency	Annual
Responsible body	MoH/(DACA)/HAPCO
Method of measurement Method of measurement	Numerator: Number of people (i.e., adults and children) with advanced HIV infection who receive antiretroviral combination therapy according to the nationally approved treatment protocol A: Number of people with advanced HIV infection receiving treatment at start of year + B: Number of people with advanced HIV infection who commenced treatment in the last 12 months _ C: Number of people with advanced HIV infection for whom treatment was terminated in the last 12 months (including those who died) Denominator: Number of people with advanced HIV infection The denominator is estimated to be 15% of the total number of people currently infected (based on the most recent national Sentinel Surveillance data). Note: Private sector antiretroviral provision should be included in the calculation of the indicator wherever possible and the extent of such provision should be recorded separately
Remark	UNGASS and WHO indicator


CST4: Health facilities providing or referring for care and support services
Definition	Percentage of health facilities that either provide comprehensive care and support services onsite for people living with HIV/AIDS or through an effective referral system (disaggregated by region)
Purpose	To assess progress on availability of comprehensive care and support services for PLWHA
Measurement tool	Health facility survey
Frequency	Every 3 years
Responsible body	MoH/HAPCO
Method of measurement Method of measurement	Health facilities are randomly selected and from each facility a health provider is asked whether the facility provides or effectively refers for essential comprehensive care and support services (listed 1-4 below) Essential comprehensive care and support services include the following: 1. Medical services: outpatient or inpatient treatment of OIs and other HIV-related conditions; preventive therapies for OIs and/or TB, symptomatic palliative care, HIV testing and pre and post-test counseling; and ART 2. Psychological services: Emotional support and follow-up counseling; PLWHA support groups and/or post-test clubs; spiritual support 3. Social/legal support: Community and home-based organizations/faith-based organizations or other organizations that offer material, food, financial, or legal support for PLWHA and their families. 4. Support for OVC: Community-based organizations/faith-based organizations or other organizations that strengthen care and support interventions for orphans and vulnerable children affected by HIV/AIDS. Effective referral is defined as follows: a. Whether the facility has a referral directory or list of services in that area that include name and contact information b. If there is a referral form the health provider can name a location where clients are referred for services c. If there is a register where referrals are recorded Numerator: Number of health facilities either providing or effectively referring for essential comprehensive care and support services Denominator: Total number of health facilities surveyed
Remark	WHO indicator


CST5: Health facilities that can provide basic HIV test and clinical management
Definition	Percentage of health facilities that have the capacity and conditions to provide basic level HIV testing and HIV/AIDS clinical management (disaggregated by region)
Purpose	To assess progress on availability of basic level HIV testing and HIV/AIDS clinical management services
Measurement tool	Health facility survey
Frequency	Every 3 years
Responsible body	MoH/HAPCO
Method of measurement	Health facilities are randomly selected and assessed whether there is (are): a. A system for testing and providing results for HIV/AIDS b. Systems and qualified staff for pre and post-test counseling c. Specific medical services relevant to HIV/AIDS, and resources and supplies for providing these services d. Elements for prevention of nosocomial infections e. Trained staff and resources for providing basic interventions for prevention and medical treatments for HIV-infected persons Note: Details of each of these elements (a-e) is included in Annex3 Numerators: Number of health facilities where individual items from each component exists Number of health facilities where a, b, c, d and e exist Number of health facilities where a, b, c, d or e exist Denominators: Total number of health facilities surveyed Total number of health facilities where HIV/AIDS services in each domain are offered or relevant Note: This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003
Remark	WHO indicator


CST7: Availability of laboratories to monitor ART
Definition	Percentage of designated laboratories with the capacity to monitor ART according to national guidelines
Purpose	To assess availability and ability of laboratories to carry out minimal as well as more advanced HIV testing requirements in order to assure appropriate use of ART
Measurement tool	Reports from nationally designated labs for monitoring ART
Frequency	Annual
Responsible body	MoH/EHNRI/HAPCO
Method of measurement	In order to scale up ARV use in resource limited settings, WHO prioritize currently available testing into 4 categories: 1. Absolute minimum tests before starting ART: HIV antibody test, hemoglobin or hematocrit level 2. Basic tests: white blood cell count and differential, serum alanine or asparatate aminotransferase level, serum creatinine, blood urea nitrogen, serum glucose, and pregnancy test. 3. Desirable tests: bilirubine, amylase, serum lipid and CD4 count 4. Optional tests: viral load Numerators: Number of designated laboratories that meet minimum testing requirement for categories 1 and 2 (above) Number of designated laboratories that meet minimum testing requirement for categories 1, 2 and 3 (above) Number of designated laboratories that meet minimum testing requirement for all four categories (above) Denominator: Total number of designated laboratories
Remark	WHO indicator


CST8: External support for households with OVCs
Definition	Percentage of households caring for orphans and vulnerable children who received free external support in the last 12 months (disaggregated by age and sex of OVC, region and source, type and level of free support)
Purpose	To assess free external supports given to households with orphans and vulnerable children
Measurement tool	Population-based survey
Frequency	Every 5 years
Responsible body	MoLSA/HAPCO
Method of measurement	Respondents in a population-based survey are asked whether their household is currently caring for any orphan or vulnerable children defined here as children under the age of 18 who have at least one dead parent (mother or father) or a chronically ill parent who was very sick for 3 or more months during the last 12 months. If the household is currently caring for OVCs, the respondent is asked whether they received free external support, which refers to help coming from sources other than friends, family, or neighbors unless they are working for a community-based group or organization. Numerator: Number of households with OVCs that received (free): 1. Medical support within the last 12 months 2. Emotional/psychological support within the last 3 months 3. School-related assistance within the past 12 months 4. Other social support (including material support) within the last 3 months 5. All four types of support Denominator: Total number of households with OVCs Note: This indicator was piloted in Ethiopia during the International Care and Support Pilot in 2003
Remark	WHO and UNAIDS indicator


CST9: External support to OVCs
Definition	Number of orphans and vulnerable children who received free external support in the last 12 months (disaggregated by age and sex of OVC, region and type and level of free support)
Purpose	To assess availability and coverage of free socioeconomic and material support to orphans and vulnerable children
Measurement tool	Program report
Frequency	Annual
Responsible body	HAPCO
Method of measurement	Orphan or vulnerable children defined here as children under the age of 18 who have at least one dead parent (mother or father) or a chronically ill parent who was very sick for 3 or more months during the last 12 months All stakeholders providing any type of free support to orphans and vulnerable children are expected to report HAPCO about the number of OVCs and type and level of support such as medical, emotional/psychological, school-related or economic (including material support)
Remark


CST10: Orphans’ school attendance
Definition	Ratio of current school attendance among orphans to that among non-orphans aged 10-14 (disaggregated by age, sex, region and urban/rural)
Purpose	To assess progress in preventing relative disadvantage in school attendance among orphans versus non-orphans
Measurement tool	Population-based survey
Frequency	Every 5 years
Responsible body	MoLSA/MoE/CSA/HAPCO
Method of measurement Method of measurement	Ratio of the current school attendance rate of children aged 10-14 both of whose biological parents have died to the current school attendance of children aged 10-14 whose parents are both still alive and who currently live with at least one biological parent. Orphans’ school attendance (1): Numerator: Number of children who have lost both parents and are still in school Denominator: Number of children who have lost both parents Non-orphans’ school attendance (2): Numerator: Number of children, both of whose parents are still alive, who live with at least one parent and who are still in school Denominator: Number of children whose parents are both still alive and who live with at least one parent Calculation of the indicator (ratio): (1) to (2) Note: Indicator scores required for boys and girls separately. Where possible, the indicator should also be calculated by single years of age The minimum number of orphaned 10-14-year-old children needed to calculate this indicator is 50.
Remark	UNGASS indicator


CST12: PLWHA’s knowledge of rights and obligations
Definition	Percentage of PLWHA who correctly know their rights and obligations under the law (disaggregated by age, sex and region)
Purpose	To assess progress made in increasing knowledge about rights and obligations of PLWHA
Measurement tool	Special study
Frequency	Every 3 years
Responsible body	HAPCO/MoJ/HAPCO
Method of measurement	PLWHA will be asked on key questions regarding their rights and obligations (the specific questions on rights and obligations of PLWHA will be constructed in consultation with MoJ and relevant individuals) Numerator: Number of PLWHA who gave the correct answers to all questions Denominator: Number of PLWHA who gave answers (including "do not know") to all questions Note: Indicator score should also be reported for each question
Remark


CST13: HIV/AIDS related court cases timely settled
Definition	Percentage of HIV/AIDS related court cases in the last 12 months that were settled in the same period
Purpose	To assess progress made in timely settling HIV/AIDS related court cases
Measurement tool	Special study
Frequency	Every 3 years
Responsible body	MoJ/HAPCO
Method of measurement	Courts and cases will be randomly selected from all regions and assessed on timely settling HIV/AIDS related cases Numerator: Number of HIV/AIDS related court cases in the last 12 months that were settled in the same period Denominator: Number of HIV/AIDS related court cases in the last 12 months
Remark


PS1: Workplace HIV/AIDS control
Definition	Percentage of large enterprises/companies that have HIV/AIDS workplace policies and programs
Purpose	To assess progress in implementing workplace policies and programs to combat HIV/AIDS
Measurement tool	Work place survey
Frequency	Every 2 years
Responsible body	HAPCO/CETU/EEF
Method of measurement	Survey of the 30 largest employers (12 private and 18 public) will be conducted. Private sector employers are selected on the basis of the size of the labour force. Public sector employers will include, among others, the ministries of transport, labour, tourism, education, defense, agriculture and health. Employers are asked to state whether they are currently implementing personnel policies and procedures that cover, as minimum, all of the following aspect(s): 1. Prevention of stigmatization and discrimination on the basis of HIV infection status in: (a) staff recruitment and promotion; and (b) employment, sickness and termination benefits 2. Workplace-based HIV/AIDS prevention, control and care programs that cover: (a) the basic facts on HIV/AIDS; (b) specific work-related HIV transmission hazards and safeguards; (c) condom promotion; (d) VCT; (e) STI diagnosis and treatment; and (f) provision of HIV/AIDS-related drugs Numerator: Number of employers with HIV/AIDS policies and regulations that meet all of the above criteria Denominator: Number of employers surveyed (30)
Remark	UNGASS indicator adapted to National need


PS2: HIV/AIDS activities integrated into sector plans
Definition	Percentage of government offices that have integrated specific HIV/AIDS activities into their sector plan in the last 12 months
Purpose	To assess progress in integrating HIV/AIDS activities into the regular sector plan
Measurement tool	Survey of government agencies
Frequency	Every 2 years
Responsible body	HAPCO
Method of measurement	15-20 government agencies including ministries, authorities, and commissions are randomly selected and assessed whether HIV/AIDS activities are included into their annual plans. Existence of HIV/AIDS related activities and allocated resources (finance, personnel and time) are checked. Numerator: Number of government offices who integrated HIV/AIDS activities into sector plan Denominator: Number of government offices surveyed
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PS3: Researches carried out
Definition	Number of national level HIV/AIDS related researches carried out in the last 12 months
Purpose	To assess the focus given and capacity to conduct HIV/AIDS related research activities
Measurement tool	Program reports/Review of research papers
Frequency	Annual
Responsible body	HAPCO
Method of measurement Method of measurement	The indicator will be measured by counting the number researches conducted at national level in the following areas Impact assessments on Education, Labor, Health and Agriculture Operational Research on ART (e.g. compliance, resistance), PEP and ABE Major nationwide HIV/AIDS surveys (e.g. DHS, BSS) Note: A database system will be established to track all HIV/AIDS related researches conducted in the country. The database will also track important researches and evaluation results conducted at national level, in specific locations of the country as well as in other countries. The database system, web based, will be accessible to researchers and other users. All partners conducting HIV/AIDS related research or evaluation of intervention programs should send a copy of the research/evaluation report(s) to HAPCO
Remark


PS4: HIV Sentinel Surveillance sites
Definition	Number of National HIV Sentinel Surveillance sites existing at the time of data collection (disaggregate by regions and urban /rural)
Purpose	To assess the geographic coverage of HIV sentinel sites
Measurement tool	Program report
Frequency	Every 2 years
Responsible body	MoH/HAPCO
Method of measurement	Count the total number of HIV sentinel sites per Region (disaggregated by urban/rural)
Remark


PS5: Government funding for HIV/AIDS
Definition	Amount of National funds spent by Government on HIV/AIDS
Purpose	To monitor the flow of national funding for HIV/AIDS as a measure of National Government’s economic commitment to fight HIV/AIDS
Measurement tool	Document review
Frequency	Every 2 years
Responsible body	HAPCO
Method of measurement	Survey of National Government expenditure on HIV/AIDS programs. The cost of any multilateral or bilateral international donor-funded government programs should be excluded. Similarly, all local NGO programs should be excluded, except for programs (or part of programs) that are funded by the national government. Allocated national funds comprise expenditure on the following four categories of programs, totals for each of which should be specified separately: 1. STD control activities 2. HIV prevention 3. HIV/AIDS clinical care and treatment 4. HIV/AIDS impact mitigation Note: It may be difficult to disaggregate Government fund by the above four categories. Even though, effort will be made to disaggregate the indicator, in the early stage of compiling the indicator lump sum will be accepted.
Remark	UNGASS indicator