Percent of health facilities providing STI services with adequate drug supply
This indicator measures the percent of health facilities providing sexually transmitted infection (STI) care that have a current supply of essential STI drugs and report no stockouts lasting longer than one week in the preceding 12 months
Countries promoting syndromic management of STIs usually have protocols for the prescriptions of drugs by syndrome as well as a national essential drug list that includes the relevant drugs. Drugs necessary to treat each of the important syndromes should appear in the stock-check for this indicator. A survey of randomly selected facilities providing STI services checks for current supplies of designated drugs. Clinic management is questioned about stockouts in the last 12 months, and clinic stock records are reviewed for that period. Client numbers are also recorded. The sampling frame for the selection of sites may include private clinics and hospitals and non-government services, as well as public facilities.
Evaluators may construct the indicator weighting each facility by its client load because a rupture of stock at a small rural clinic will have less impact on the epidemic at a national level than a stockout in a large urban clinic that sees many times more patients.
This indicator is calculated as:
(Number of health facilities providing STI services that have a current supply of essential STI drugs and report no stockouts / Total # of health facilities providing STI services) x 100
Depending on national policy, the indicator may include a variety of outlets providing services for HIV care, such as integrated reproductive health services, private sector facilities, and pharmacies with special training in STI care provision.
Assessment by an external evaluator
WHO/UNAIDS revised guidelines on evaluating STI services; MEASURE Service Provision Assessment (SPA)
Correct history-taking, diagnosis, and prescription are all very well, but if drugs are unavailable, these procedures will not translate into cases cured and will therefore not reduce the likelihood of HIV infection.
National AIDS programs engaged in improving STI services have put time and money into improving drug distribution services and in attempting to ensure adequate manufacturing or importing of drugs for the syndromic management of STIs. This indicator measures the effectiveness of those efforts in ensuring that service providers are consistently supplied with the drugs they need to work efficiently.
This indicator is a good measure of consistent supplies of drugs to STI service facilities; it provides a minimum measure of the availability of drugs. However, clients very often buy drugs from other sources, even when they have been to an STI facility for diagnosis. Indeed, in countries where control of drug supplies are lax, a stockout in a public clinic may simply mean that the supply of drugs has been diverted to another nearby outlet. This laxity will likely affect the cost of the drug to the client (and therefore accessibility), but it may not affect the physical availability of the drug.
Again, the selection of STI facilities may have a major influence on the indicator. The facility survey should attempt to include a mix of all major provider categories in both the public and the private sectors.
management, commodity, sexually transmitted infection (STI), HIV/AIDS, quality, cervical cancer