Number of national, provincial, or district level policies, frameworks or guidelines, that include HTSP recommendations
Policies, frameworks or guidelines may include reproductive health policies, family planning strategies including counseling recommendations, pre-service and in-service curricula for health providers, etc. The healthy timing and spacing of pregnancy (HTSP) recommendations must be accurate and up-to-date to be included.
According to a WHO technical consultation on birth spacing and USAID, the three recommendations that make up the basis of the key HTSP messages are:
- After a live birth, the recommended interval before attempting the next pregnancy should be at least 24 months (this is equivalent to a 33 month birth-to-birth interval);
- After a miscarriage or induced abortion, the recommended minimum interval to next pregnancy should be at least six months; and
- To delay first pregnancy until at least 18 years of age.
As a proportion, this indicator is calculated as:
(Number of health and non-health workers trained in HTSP who can correctly state the three HTSP recommendations / total number of health and non-health workers trained in HTSP) x 100
Number of persons trained (based on an actual list of names for potential verification purposes), their professional positions or community affiliation (e.g. nurse-midwife, religious leader, youth group member), and verification that the trainee correctly identified the three HTSP recommendations
Training record that evaluates knowledge retained, such as a post-test
This indicator goes one step further than strictly recording number of people trained; it helps project implementers evaluate the effectiveness of an HTSP training by asking training participants to identify the three key recommendations that form the basis of all HTSP messages. Having this information is useful for assessing effectiveness of and knowledge gaps in HTSP trainings.
The indicator, as stated, is not sensitive enough to identify how many or which recommendation(s) a trainee did not identify correctly. Also, it does not indicate if the trainee understands the rationale for the three recommendations. Evaluators can improve this indicator by making it the aggregate of three separate indicators measuring the number/percent of trainees who stated the first recommendation correctly, the second recommendation correctly, and the third recommendation correctly.
policy, healthy timing and spacing of pregnancies (HTSP)
“Healthy Timing and Spacing of Pregnancy: A Trainer’s Reference Guide”, 2008. USAID and ESD Project
“Healthy Timing and Spacing of Pregnancies: A Pocket Guide for Health Practitioners, Program Managers, and Community Leaders”, 2006. USAID and ESD Project