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MER 2.3 Updates

November 30, 2018

MER 2.3 Updates

Review of changes made to the PEFPAR MER 2.3 indicators


November 30, 2018


  1. PEPFAR’s focus with MER is to program and then monitor

    for impact. Indicators continue to evolve to adapt to emerging programmatic areas and advances in technical approaches to implementation as countries begin to reach epidemic control. WHY?
  2. • the need for further standardization of age, sex and

    key population disaggregations across the prevention and clinical cascades; • the need to reduce data collection redundancies between indicators and ensure that the MER guidance and training materials reinforce the relationships within and between indicators; • the need for enhancements to the data entry screens in DATIM to ensure better data quality; and • the need for more input on MER changes from community stakeholders, technical experts, implementing partners, and PEPFAR field staff. MOTIVATIONS
  3. May Sept The revision process started in May, fielding feedback.

    After reviewing and drafting new guidance, the updates were released in September.
  4. AGYW_PREV NEW INDICATOR prevention | semi-annual • DREAMS specific •

    measure how many adolescent girls and young women are being served in the DREAMS program and whether all AGYW in DREAMS have received the intended layered services and interventions to ensure that they remain HIV-free * see the appendix for disaggregates
  5. PrEP_CURR NEW INDICATOR prevention | semi-annual • measures the number

    of individuals receiving oral PrEP during the reporting period and is an important addition to the MER to help PEPFAR programs understand how many clients are being sustained on PrEP after initiation. * see the appendix for disaggregates
  6. CXCA_SCRN NEW INDICATOR testing | semi-annual • measures the percentage

    of HIV-positive women on ART screened for cervical cancer * see the appendix for disaggregates
  7. HTS_INDEX NEW INDICATOR testing | quarterly • measures individuals who

    were identified and tested using Index testing services and received their results • standalone indicator to monitor index testing services • includes a cascade that will help to better understand the scale and fidelity of the index testing services provided by PEPFAR-supported programs * see the appendix for disaggregates
  8. HTS_RECENT NEW INDICATOR testing | quarterly • measures the percentage

    of newly diagnosed HIV- positive persons aged ≥15 years with a test for recent infection result of ‘recent infection’ during the reporting period • as countries progress toward epidemic control, surveillance of newly diagnosed persons will ensure that interventions target those at highest risk of acquiring or transmitting HIV infection. * see the appendix for disaggregates
  9. CXCA_TX NEW INDICATOR treatment | semi-annual • measures the percentage

    of cervical cancer screen- positive women who are also HIV-positive and on ART that were eligible for and received cryotherapy, thermocoagulation or LEEP * see the appendix for disaggregates
  10. TX_ML NEW INDICATOR treatment | semi-annual • measures the number

    of ART patients with no clinical contact since their last expected contact • intended to drive improved tracing of patients to ensure patient outcomes are accurately documented. • first PEPFAR indicator to collect information on mortality and strives to better understand the magnitude of previously undocumented patient transfers. * see the appendix for disaggregates
  11. HTS_TST – new testing modality introduced, Post ANC1: Pregnancy/L&D/BF PP_PREV

    – new, optional priority populations added AGYW, Adult men/women, sex worker clients, displaced persons, fishing communities, military, mobile populations, non-injecting drug users TX_TB – denominator updated to include a new disaggregate for “positive result returned.” NEW DISAGGREGATIONS
  12. OVC_HIVSTAT – sub-disaggregate under “No status reported” formerly called “Test

    not indicated” will now be “Test not required based on risk assessment” to simplify the language. OVC_SERV – age/sex and program status (i.e., active or graduated) disaggregations have been combined DISAGGREGATION CHANGES
  13. PMTCT_STAT – age disaggregations were added to the “maternal regimen

    type” disaggregate to align with PMTCT_STAT PrEP_NEW – “Other key population” has been removed and replaced with “people who inject drugs” and “people in prisons and other closed settings” so that all key population disaggregate group options align between HTS_TST, TX_NEW, PrEP_CURR, and PrEP_NEW. DISAGGREGATION CHANGES
  14. TB_ART – age/sex and “ART status” disaggregations have been combined

    TB_STAT – age/sex disaggregations were updated from coarse-only to fine age bands to allow TB_STAT to auto- populate HTS_TST via the TB modality and to align with the age bands for TB_ART. DISAGGREGATION CHANGES
  15. TX_TB – age/sex and “ART Status” disaggregations have been combined

    for the numerator. Age/sex and “Start of ART by Screen Results” disaggregations have been combined for the denominator. VMMC_CIRC – age disaggregations were added to the “HIV Status and Outcome” disaggregate in order for VMMC HTS results to auto-populate into the HTS_TST indicator. DISAGGREGATION CHANGES
  16. TX_CURR Lost To Follow Up - Patients who have not

    received ARVs within four weeks of their last missed drug pick-up should not be counted. Efforts to trace patients that have missed a clinical visit or drug pick-up should begin immediately following a missed clinical contact. TX_ML describes the PEPFAR-recommended patient tracing process in more detail. DEFINTION CHANGE
  17. <1 1-4 5-9 10-14 15-19 20-24 25-29 30-2 Auto-sum Total

    Numerator & Total Denominator DSD: TX_NEW Female Male Total Numerator DATIM CHANGES
  18. Auto-population of some HTS modalities HTS_TST Emergency Inpatient Mal- nutrition

  19. Key dates for each data entry period in FY19 PEPFAR

    DATA CALENDAR Data Entry Cleaning & Resubmission Opens Closes Opens Closes Q1 7 Jan 15 Feb 4 Mar 22 Mar Q2 1 Apr 15 May 3 Jun 21 Jun Q3 1 Jul 15 Aug 2 Sep 20 Sep Q4 1 Oct 15 Nov 2 Dec 20 Dec ~ 6-7 weeks ~ 2-3 weeks
  20. IP Data Review, Validation, Revision, & Analysis DATA CLEANING IP

    Data Collection & Entry IP Submission to USG Agency USG Agency Data Review & Validation USG Interagency Data Review & Validation USG Agency Submission to USG Interagency USG Interagency Data Deduplication & Analysis USG Interagency Submission to USG HQ ALL USG Data Review & Validation Frozen Dataset Available
  21. • Prepared for an USAID partner meeting in Abuja, Nigeria

    by Aaron Chafetz (USAID). • Reference Material • Nichols, C. (2018). PEPFAR Data Refresher for USAID Haiti (presentation). • PEPFAR. (2018). MER Indicator Reference Guide for FY19 Reporting (presentation). • PEPFAR. (2018). MER Reference Guide (Version 2.3 FY19). Notes and Attribution