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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 programs 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 dont really know to what extent youre 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

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?

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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
------------------------------------------# of individuals in target population

X 100

Utilization calculation: Example


No. of persons educated as of 6/12/09 = 300
Goal for 12/31/09 = 900
300
900

= 0.33 x 100 =
33%

You have reached 33% of your target group with


education messages

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

Utilization of PMTCT Programs


All pregnant women
(2,000)
PMTCT
Target
(1,000)

Target population

Sought prenatal care


(600)

Utilization =

Utilization =
Service users

600/1,000 = 0.6
Counseled & Tested for
HIV (500)

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.

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)

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Retention example: Immunization


Utilization

Completion

All pregnant women


(2,000 women)

PMTCT Program Retention

PMTCT
Target
(1,000)
Sought prenatal care (600)
350 received HIVresult or no result
Tested for HIV (500)
40 received
prophylaxis

100 received HIV+


result

All pregnant women (2,000


women)

PMTCT Program Retention

1,000
Sought prenatal care
500
Tested for HIV
40 received
prophylaxis

350 received HIVresult


100 received HIV+
result

All pregnant women


(2,000 women)

PMTCT Program Retention

PMTCT
Target
(1,000)
Sought prenatal care (600)
350 received HIVresult
Tested for HIV (500)
40 received
prophylaxis

100 received HIV+


result

All pregnant women


(2,000 women)

PMTCT Program Retention

PMTCT
Target
(1,000)
Sought prenatal care (600)
350 received HIVresult or no result
Tested for HIV (500)
40 received
prophylaxis

100 received HIV+


result

All pregnant women


(2,000 women)

PMTCT Program Retention

PMTCT
Target
(1,000)
Sought prenatal care (600)
350 received HIVresult or no result
Tested for HIV (500)
40 received
prophylaxis

100 received HIV+


result

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