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Health Information System (HIS)

Standards and Indicators Guide

Revised January 2010

XXXXX XXXXX_EN_ddmmyy Health Information System Standards and Indicators Guide

Introduction Statistics

Section This Guide lists the standards and indicators used within the Health Information System (HIS). It is designed as a reference 1.0 Population 6 tool, to help interpret indicators presented in HIS reports and to improve decision-making based on this information. 2.0 Mortality 9 3.0 Morbidity 12 Indicators are referenced according to each section of the HIS. This numbering is consistent throughout the HIS toolkit 4.0 IPD and Referral 8 and HIS database, and helps to identify the tools, forms and 5.0 Laboratory 6 guidelines that are required to collect and report each indicator. 6.0 Control 1

7.0 EPI 5 Corresponding standards are presented where available. These should be modified according to regional or country- 8.0 25 specific data. For indicators that have no reference standard, estimates should be derived from previous health reports. 9.0 20 10.0 HIV/AIDS 18

Total * 110

* does not include full disaggregation of indicators (e.g. into cause-specific rates; antigen-specific coverage rates)

Page 2 Health Information System Standards and Indicators Guide

c. Consultations per clinician per day ...... 12

Table of Contents d. Proportional service use by Nationals ...... 12 3.2 Morbidity 13 1.0 POPULATION 6 e. Incidence Rate...... 13 f. Proportional Morbidity Rate ...... 13 1.0 Population 7 3.3 Outbreak Alert and Response 13 a. Total population ...... 7 g. Number of outbreaks reported...... 13 b. Live births ...... 7 h. Timing of Outbreak Investigation ...... 13 c. under one...... 7 3.4 Sexually Transmitted (STI) 14 d. Children under five...... 7 i. Incidence of Male Urethral Discharge...... 14 e. Female 15-49 years of age...... 7 j. Incidence of Genital Ulcer Disease...... 14 f. Pregnant and Lactating women...... 7 k. Proportion of STI among Under 18s ...... 14 2.0 MORTALITY 8 l. Partner Tracing ...... 14 2.1 Mortality by Age 9 4.0 INPATIENT DEPARTMENT AND REFERRAL 15 a. Crude (CMR) ...... 9 4.1 Inpatient Department Activities 16 b. Under 5 Mortality Rate (U5MR) ...... 9 a. Number of patients at the end of the month ...... 16 c. Mortality Rate (IMR)...... 9 b. Proportion of U5 within 24 hours...... 16 d. Neonatal Mortality Rate (NNMR)...... 9 c. Average Length of Stay ...... 16 Gender-specific Mortality Rate ...... 9 d. Bed Occupancy Rate...... 16 2.2 Mortality by Cause 10 e. Hospitalisation Rate...... 16 Maternal Mortality Ratio (MMR)...... 10 f. Proportional Service use by Nationals...... 17 e. Proportional Mortality Rate ...... 10 4.2 Inpatient Department Admissions and Deaths 17 2.3 Maternal Reporting and Investigation 10 g. ...... 17 f. Number of maternal deaths reported...... 10 4.3 Referral 17 g. Investigation of maternal deaths...... 10 h. Referral Rate...... 17 3.0 MORBIDITY 11 5.0 LABORATORY 18 3.1 Consultation 12 5.1 19 a. Total number of consultations ...... 12 a. Malaria Slide Positivity Rate ...... 19 b. Health Facility Utilization Rate...... 12 b. RDT Positivity Rate...... 19

Page 3 Health Information System Standards and Indicators Guide

5.2 Tuberculosis 19 g. Coverage of SFP (Pregnant and Lactating) ...... 28 c. Sputum Smear Positivity Rate ...... 19 8.2 Therapeutic Feeding Program 28 5.3 Blood Donation 20 a. Number of new admissions to TFP...... 28 d. Quality of blood donation screening ...... 20 b. Mean Length of Stay (U5)...... 28 5.4 RPR Testing (OPD) 20 c. Average Weight Gain (U5)...... 29 e. Syphilis Rate (OPD) ...... 20 d. Recovery Rate (U5) ...... 29 f. Partner Tracing ...... 20 e. Death Rate (U5)...... 29 f. Default Rate (U5)...... 29 6.0 DISEASE CONTROL 21 g. Coverage of TFP (U5)...... 30 6.1 Tuberculosis 22 8.3 Community-based Therapeutic Care (CTC) 30 Treatment Success Rate ...... 22 8.3a Stabilisation Centre (SC) 30 a. Number of new admissions to SC ...... 30 7.0 EPI 23 b. Mean Length of Stay (U5)...... 30 7.1 Children Vaccinated 24 c. Stabilisation Rate (U5) ...... 30 a. Coverage Rate...... 24 8.3b Outpatient Therapeutic Program (OTP) 30 b. Program Drop Out Rate...... 24 a. Number of new admissions to OTP...... 30 7.2 Vaccine Wastage 24 b. Mean Length of Stay (U5)...... 31 c. Vaccine Wastage Rate ...... 24 c. Average Weight Gain (U5)...... 31 7.3 Vitamin A Distribution 25 d. Recovery Rate (U5) ...... 31 d. Postnatal Vitamin A Coverage Rate ...... 25 e. Death Rate (U5)...... 31 7.5 Growth Monitoring 25 f. Default Rate (U5)...... 31 e. Growth Monitoring Utilisation (U5)...... 25 g.Proportion of children requiring inpatient care...... 32 h.Coverage of CTC (U5)...... 32 8.0 NUTRITION 26 8.1 Supplementary Feeding Program 27 9.0 REPRODUCTIVE HEALTH 33 a. Number of new admissions to SFP ...... 27 9.1 Antenatal Care 34 b. Mean Length of Stay (U5)...... 27 a. Timing of first Antenatal Visit ...... 34 c. Recovery Rate (U5) ...... 27 b. Coverage of Syphilis Screening...... 34 d. Death Rate (U5)...... 27 c. Prevalence of Syphilis...... 34 e. Default Rate (U5)...... 27 d. ratio...... 34 f. Coverage of SFP (U5) ...... 28 e. Coverage of Complete Antenatal Care...... 35

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f. Coverage of Toxoid ...... 35 f. Post test Counseling and Result (ANC partners) ...... 42 g. Coverage of Intermittent Presumptive Treatment for Malaria ..... 35 g. Proportional PMTCT service use by Nationals...... 42 9.2 Delivery Care 36 10.4 PMTCT (Labour and Delivery) 43 i. Crude Birth Rate ...... 36 h. Antiretroviral Propylaxis () ...... 43 j. Proportion of Births Attended by Skilled Health Worker ...... 36 i. Antiretroviral Propylaxis (Infant)...... 43 k. Proportion of Deliveries at EmOC facility...... 36 j. Proportional ARV Use (Mother-Infant Pair)...... 43 l. Proportion of Low newborns ...... 36 10.5 PMTCT (Postnatal) 44 m. Management of obstetric complications ...... 37 k. Exclusive Breastfeeding Rate ...... 44 Rate ...... 37 l. Home-based Counselling...... 44 n. Proportion of all birth performed by caesarian section ...... 37 m. Planning Acceptance Rate...... 44 9.3 Postnatal Care 38 n. Co-trimoxazole Prophylaxis (mother) ...... 44 o. Coverage of Complete Postnatal Care...... 38 o. Co-trimoxazole Prophylaxis (infant)...... 45 9.4 38 Infant HIV positivity rate...... 45 p. Contraceptive Prevalence Rate...... 38 9.5 Sexual and Gender-based Violence (SGBV) 38 q. Incidence of Reported Rape...... 38 r. Timing of ECP Provision...... 39 s. Timing of PEP Prophylaxis ...... 39 t. Timing of STI Presumptive Treatment...... 39

10.0 HIV/AIDS 40 10.1 Condom Distribution 41 a. Condom Distribution Rate...... 41 10.2 Voluntary Counselling and Testing 41 HIV Prevalence Rate (VCT)...... 41 b. Post test Counseling and Result ...... 41 c. Proportional VCT service use by Nationals ...... 41 10.3 PMTCT (Antenatal) 42 d. PMTCT Coverage Rate ...... 42 HIV Prevalence Rate (PMTCT) ...... 42 e. Post test Counseling and Result ...... 42

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Health Information System (HIS)

Standards and Indicators Guide

1.0 Population

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Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

1.0 Population • Page 6

Health Information System Standards and Indicators Guide

1.0 Population

S/N Indicator Name Type Description Formula Units Standard Source Remarks 1. a. Total Total number of From proGres Number Disaggregated population persons by sex

2. b. Live births Number of live births Figure taken from Number Disaggregated Delivery Registers by sex. For Crude Birth Rate see Section 9.2m 3. c. Infants under Number of infants < 1 From proGres Number Disaggregated one year of age by sex

4. d. Children Number of children From proGres Number Disaggregated under five under 5 years of age by sex

5. e. Female 15-49 Number of women Total population x 0.2 Number 20% of years of age aged 15-49 (of total reproductive age) population

6. f. Pregnant and Number of women who Total population x Number 4% of Assuming Lactating are pregnant and 0.04 total CBR of women lactating population approx. 35 per year.

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Health Information System Standards and Indicators Guide

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Standards and Indicators Guide

2.0 Mortality

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Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

2.0 Mortality • Page 8

Health Information System Standards and Indicators Guide

2.1 Mortality by Age

S/N Indicator Name Type Description Formula Units Standard Source Remarks 7. a. Crude Impact Rate of deaths in the Total number of / 1000 < 1.5 SPHERE Disaggregated Mortality Rate total population deaths / Total population / deaths / by sex (see (CMR) population x 1000 month 1000 / gender month specific mortality rate) 8. b. Under 5 Impact Rate of deaths among Number of deaths / 1000 < 3 SPHERE Disaggregated Mortality Rate children under five among under fives / population / deaths / by sex (see (U5MR) Total under five month 1000 / gender population x 1000 month specific mortality rate) 9. c. Impact Rate of deaths among Number of deaths / 1000 live < 60 SPHERE Disaggregated Rate (IMR) infants under one among under ones / births deaths / by sex (see Total number of live 1000 live gender births x 1000 births specific mortality rate) 10. d. Neonatal Impact Rate of deaths among Total number of / 1000 live < 40 SPHERE Mortality Rate newborns within the deaths for newborns births deaths (NNMR) first 28 days of life < 28 days of life / /1000 live Total number of live births births x 1000 11. Gender-specific Impact Rate of deaths among Number of male (or / 1000 Disaggregated Mortality Rate males (or females) in female) deaths within population / by crude, U5 the population specified age group / month and infant. Population within same age group x 1000

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Health Information System Standards and Indicators Guide

2.2 Mortality by Cause

S/N Indicator Name Type Description Formula Units Standard Source Remarks 12. Maternal Impact Rate of - Number of / 100 000 SPHERE Presented in Mortality Ratio related deaths* among pregnancy-related live births specific (MMR) the population deaths / Total reports as number of live births annualised x 100000 figures only, * Death within as more pregnancy or within 42 stable days of termination of reference pregnancy 13. e. Proportional Impact Proportion of deaths Number of deaths % No more SPHERE Disaggregated Mortality Rate attributable to a due to a particular than 25% by crude and particular cause cause / Total number of under five among the population of deaths x 100 proportional mortality should be in "others" column

2.3 Reporting and Investigation

S/N Indicator Name Type Description Formula Units Standard Source Remarks 14. f. Number of Process Number of reported Number IAWG RH maternal deaths maternal deaths reported

15. g. Investigation Process Proportion of reported Number of maternal % IAWG RH of maternal maternal deaths which deaths investigated / SPHERE deaths are investigated\ Number of maternal deaths

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3.0 Morbidity

(

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

3.0 Morbidity • Page 11

Health Information System Standards and Indicators Guide

3.1 Consultation

S/N Indicator Name Type Description Formula Units Standard Source(s) Remarks 16. a. Total number Process Total number of Number of consultations consultations (new and revisit; Refugee and National) 17. b. Health Facility Outcome Rate at which new Number of new visits / refugee / 1.0 - 4.0 new UNHCR Utilization Rate visits are made to made in one camp / year visits / SPHERE health facilities in one Total population x 12 refugee / year year 18. c. Consultations Outcome Rate at which Total number of consultations < 50 UNHCR per clinician per consultations are made consultations (new / clinician / consultations SPHERE day to a full time clinician and revisit; Refugee day / clinician / each day in one camp and National) / day Number of full-time equivalent trained clinicians in the camp / Number of full days OPD functioning in the month 19. d. Proportional Outcome Proportional use of Number of % service use by outpatient services by consultations to Nationals Nationals Nationals (new and revisit) / Total number of consultations (new and revisit; Refugee + National) x 100

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Health Information System Standards and Indicators Guide

3.2 Morbidity

S/N Indicator Name Type Description Formula Units Standard Source Remarks 20. e. Incidence Impact Rate of occurrence of Number of new / 1000 SPHERE Disaggregated Rate new or health cases of particular population by crude and problems in the disease / Total / month under five population population x 1000 21. f. Proportional Impact Proportion of illness Number of cases of a % No more SPHERE Disaggregated Morbidity Rate attributable to a particular disease or than 25% by crude and particular cause health event / Total of under five among the total number of cases x proportional population 100 morbidity should be in "others" column

3.3 Outbreak Alert and Response

S/N Indicator Name Type Description Formula Units Standard Source Remarks 22. g. Number of Process Number of outbreaks Number outbreaks reported reported

23. h. Timing of Outcome Proportion of reported Number of reported % SPHERE Outbreak outbreaks which are outbreaks that are Investigation investigated within 48 investigated within 48 hours hours / Number of reported outbreaks

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Health Information System Standards and Indicators Guide

3.4 Sexually Transmitted Infection (STI)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 24. i. Incidence of Impact Incidence of male Number of cases of / 1000 UNHCR Male Urethral urethral discharge male urethral population / Discharge among male population discharge reported / month Total male population x 1000

25. j. Incidence of Impact Incidence of genital Number of cases of / 1000 UNHCR Genital Ulcer ulcer disease among genital ulcer disease / population / Disease total population Total population x month 1000

26. k. Proportion of Process Proportion of syndromic Number of STIs % STI among STIs diagnosed among diagnosed among Under 18s under 18s under 18s / Total number of STIs diagnosed x 100 27. l. Partner Tracing Outcome Ratio of contacts of Number of contacts % suspected STI cases treated / Number of treated to total number cases identified x 100 of suspected STI cases

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Standards and Indicators Guide

4.0 Inpatient Department and Referral

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

4.0 Inpatient Department and Referral • Page 15 Health Information System Standards and Indicators Guide

4.1 Inpatient Department Activities

S/N Indicator Name Type Description Formula Units Standard Source Remarks 28. a. Number of Process Number of patients at Number patients at the the end of the month end of the month

29. b. Proportion of Outcome Proportion of inpatient Number of under five % UNHCR U5 deaths within deaths among under deaths within 24 24 hours fives that occur within hours of admission / 24 hours of admission Total number of under five deaths x 100 30. c. Average Outcome Average length of stay Sum of days spent in Days Length of Stay for all authorized hospital for all discharges authorized discharges / Total number of authorized discharges

31. d. Bed Outcome Average number of (Average length of % 75% UNHCR Occupancy Rate beds that are occupied stay x Number of at any point in time admissions during reporting period) / (Number of beds x Number of days during reporting period) 32. e. Hospitalisation Outcome Rate at which Number of / 1000 50-150 / UNHCR Rate individuals are admitted admissions / Total population / 1000 to hospital among the Population x 1000 x year population population 12 / year

4.0 Inpatient Department and Referral • Page 16 Health Information System Standards and Indicators Guide

33. f. Proportional Process Proportional number of Number of % Service use by inpatient admissions by admissions to Nationals Nationals Nationals / Total number of admissions (Refugee + National) x 100

4.2 Inpatient Department Admissions and Deaths

S/N Indicator Name Type Description Formula Units Standard Source Remarks 34. g. Case Fatality Outcome Fatality rate Number of deaths / % Disaggregated Rate attributable to a Number of by crude and particular cause admissions due to a under five particular cause x 100

4.3 Referral

S/N Indicator Name Type Description Formula Units Standard Source Remarks 35. h. Referral Rate Outcome Rate at which referrals Number of referrals / 1000 Disaggregated are made to other from camp according population / by types and levels of to department / Total month Emergency, health care population x 1000 District, Regional, Zonal, National and Other

4.0 Inpatient Department and Referral • Page 17 Health Information System Standards and Indicators Guide

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Standards and Indicators Guide

5.0 Laboratory

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

5.0 Laboratory • Page 18 Health Information System Standards and Indicators Guide

5.1 Malaria

S/N Indicator Name Type Description Formula Units Standard Source Remarks 36. a. Malaria Slide Outcome Proportion of malaria Number of malaria % Positivity Rate films examined which slides which were were positive for positive for malaria parasites Plasmodium falciparum / Total number of malaria slides examined x 100 37. b. RDT Positivity Outcome Proportion of malaria Number of malaria % Rate films examined which slides which were were positive for positive for malaria parasites Plasmodium falciparum / Total number of malaria slides examined x 100

5.2 Tuberculosis

S/N Indicator Name Type Description Formula Units Standard Source Remarks 38. c. Sputum Smear Outcome Proportion of sputum Number of sputum % Positivity Rate smears examined which smears which were were positive for acid positive for AFB / fast bacilli (AFB) Total number of sputum smears examined x 100

5.0 Laboratory • Page 19 Health Information System Standards and Indicators Guide

5.3 Blood Donation

S/N Indicator Name Type Description Formula Units Standard Source Remarks 39. d. Quality of Outcome Percentage of donated Number of donated % UNGASS blood donation blood units screened for blood units screened screening HIV in a quality assured for HIV in a quality manner assured manner / Total number of donated blood units screened x 100

5.4 RPR Testing (OPD)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 40. e. Syphilis Outcome Proportion of STI Number of STI % Prevalence Rate patients, who were patients tested RPR (OPD) screened for syphilis positive / Total using Rapid Plasma number of STI Reagin (RPR), who patients tested x 100 were RPR positive 41. f. Partner Tracing Outcome Ratio of contacts of Number of RPR % RPR positive cases positive contacts tested to total number tested / Number of of RPR positive cases RPR positive cases x 100

5.0 Laboratory • Page 20 Health Information System Standards and Indicators Guide

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6.0 Disease Control

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

6.0 Disease Control • Page 21 Health Information System Standards and Indicators Guide

6.1 Tuberculosis

S/N Indicator Name Type Description Formula Units Standard Source Remarks 42. Treatment Outcome Percentage of new Number of new, % Calculated in Success Rate smear positive patients registered smear- HIS database who are documented to positive (infectious) using cohort be cured, or to have cases that were cured analysis. successfully completed or completed a full Presented in treatment course / Total number specific of new, registered reports only cases x 100

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7.0 EPI (Expanded Programme on )

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

7.0 EPI • Page 23 Health Information System Standards and Indicators Guide

7.1 Children Vaccinated

S/N Indicator Name Type Description Formula Units Standard Source Remarks 43. a. Vaccination Outcome Percentage of infants Number of infants % 95% UNICEF Disaggregated Coverage Rate under one year who who finished antigen by BCG, are fully immunized course / (Total , DPT, against target disease number of infants/12) , Fully Immunized

44. b. Program Drop Outcome Proportion of infants (Number of infants % < 10 % UNICEF Out Rate not receiving all three who receive DPT 1 - required doses of DTP Number of infants after receiving an initial who receive DPT 3) / dose, compared Number of infants number of infants who who received DPT 1 receive an initial dose.

7.2 Vaccine Wastage

S/N Indicator Name Type Description Formula Units Standard Source Remarks 45. c. Vaccine Outcome Proportion of doses of (Number of doses of % < 8% UNICEF Disaggregated Wastage Rate vaccine supplied but vaccine supplied - by BCG, not administered Number of doses Polio, DPT, administered Measles, (Refugee + National) Tetanus / Number of doses Toxoid supplied

7.0 EPI • Page 24 Health Information System Standards and Indicators Guide

7.3 Vitamin A Distribution

S/N Indicator Name Type Description Formula Units Standard Source Remarks 46. d. Postnatal Outcome Proportion of women Number of women % 100% Vitamin A who received Vitamin A receiving one dose of Coverage Rate prophylaxis within 6 Vitamin A within 6 weeks of delivery weeks of delivery / Number of live births x 100

7.5 Growth Monitoring

S/N Indicator Name Type Description Formula Units Standard Source Remarks 47. e. Growth Outcome Proportion of expected Number of U5 % > 90% Monitoring number of children U5 screened for weight- Utilisation (U5) who were screened for for-age / Total weight-for-age population of U5 x 100

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Health Information System (HIS)

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8.0 Nutrition

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

8.0 Nutrition • Page 26 Health Information System Standards and Indicators Guide

8.1 Supplementary Feeding Program

S/N Indicator Name Type Description Formula Units Standard Source Remarks 48. a. Number of new Process Number of new Number admissions to admissions to SFP SFP

49. b. Mean Length Outcome Average length of stay Sum number of Weeks < 2 WFP/ of Stay (U5) for U5 children who weeks of admission months UNHCR recovered for U5 children who recovered / Number U5 exits due to recovery 50. c. Recovery Rate Outcome Proportion of U5 exits Number of U5 % > 75% WFP/ Disaggrega (U5) from SFP due to recovered / Total UNHCR ted by recovery number of U5 exits x Refugee 100 and National

51. d. Death Rate Outcome Proportion of U5 exits Number of U5 deaths % < 3% WFP/ Disaggrega (U5) from SFP due to death / Total number of U5 UNHCR ted by exits x 100 Refugee and National

52. e. Default Rate Outcome Proportion of U5 exits Number of U5 % < 15% WFP/ Disaggrega (U5) from SFP due to default defaulters / Total UNHCR ted by number of U5 exits x Refugee 100 and National

8.0 Nutrition • Page 27 Health Information System Standards and Indicators Guide

53. f. Coverage of Outcome Percentage of expected Number of U5 % > 90% SFP (U5) number of moderately enrolled at end of the malnourished children month / (Estimated U5 who are enrolled in moderate acute SFP rate x population U5) x 100

54. g. Coverage of Outcome Percentage of expected Number of pregnant % SFP (Pregnant number of pregnant and and lactating in SFP and Lactating) lactating women who are at end of the month / enrolled in SFP Expected number of pregnant and lactating women in the camp

8.2 Therapeutic Feeding Program

S/N Indicator Name Type Description Formula Units Standard Source Remarks 55. a. Number of new Process Number of new Number admissions to admissions to TFP TFP

56. b. Mean Length Outcome Average length of stay Sum number of days Days < 30 days WFP/ Disaggrega of Stay (U5) for U5 children who of admission for U5 UNHCR ted by recovered children who Marasmus recovered / Number and U5 exits due to Kwash’rkor recovery

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57. c. Average Outcome Average number of Sum [(weight on exit - g / kg / day > 8 g / kg / WFP/ Disaggrega Weight Gain (U5) grams that recovered lowest weight day UNHCR ted by children gained per kg recorded during Marasmus per day since admission recovery(g)) / lowest and in TFP weight recorded Kwash’rkor during recovery (kg) / otal number of days between exit and lowest weight recorded during recovery] / Number of recovered children 58. d. Recovery Rate Outcome Proportion of U5 exits Number of U5 % > 75% WFP/ Disaggrega (U5) from TFP due to recovered / Total UNHCR ted by recovery number of U5 exits x Refugee 100 and National

59. e. Death Rate Outcome Proportion of U5 exits Number of U5 deaths % < 10% WFP/ Disaggrega (U5) from TFP due to death / Total number of U5 UNHCR ted by exits x 100 Refugee and National

60. f. Default Rate Outcome Proportion of U5 exits Number of U5 % < 15% WFP/ Disaggrega (U5) from TFP due to default defaulters / Total UNHCR ted by number of U5 exits x Refugee 100 and National

8.0 Nutrition • Page 29 Health Information System Standards and Indicators Guide

61. g. Coverage of Outcome Percentage of expected Number of U5 % > 90% TFP (U5) number of severely enrolled at end of the malnourished children month / (Estimated U5 who are enrolled in severe acute TFP malnutrition rate x population U5) x 100

8.3 Community-based Therapeutic Care (CTC)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 8.3a Stabilisation Centre (SC) 62. a. Number of new Process Number of new Number admissions to SC admissions to SC

63. b. Mean Length Outcome Average length of stay Sum number of days Days Disaggrega of Stay (U5) for U5 children who of admission for U5 ted by recovered children who Marasmus recovered / Number and U5 exits due to Kwash’rkor recovery 64. c. Stabilisation Outcome Proportion of children Number of U5 % Disaggrega Rate (U5) successfully stabilised discharges to OTP / ted by Total number of U5 Marasmus exits x 100 and Kwash’rkor 8.3b Outpatient Therapeutic Program (OTP) 65. a. Number of new Process Number of new Number admissions to admissions to OTP OTP

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66. b. Mean Length Outcome Average length of stay Sum number of Weeks Disaggrega of Stay (U5) for U5 children who weeks of admission ted by recovered for U5 children who Marasmus recovered / Number and U5 exits due to Kwash’rkor recovery 67. c. Average Outcome Average number of Sum [(weight on exit - g / kg / day Disaggrega Weight Gain (U5) grams that recovered lowest weight ted by children gained per kg recorded during Marasmus per day since admission recovery(g)) / lowest and in OTP weight recorded Kwash’rkor during recovery (kg) x total number of days between exit and lowest weight recorded during recovery] / Number of recovered children 68. d. Recovery Rate Outcome Proportion of U5 exits Number of U5 % Disaggrega (U5) from OTP due to recovered / Total ted by recovery number of U5 exits x Refugee 100 and National 69. e. Death Rate Outcome Proportion of U5 exits Number of U5 deaths % Disaggrega (U5) from OTP due to death / Total number of U5 ted by exits x 100 Refugee and National 70. f. Default Rate Outcome Proportion of U5 exits Number of U5 % Disaggrega (U5) from OTP due to default defaulters / Total ted by number of U5 exits x Refugee 100 and National

8.0 Nutrition • Page 31 Health Information System Standards and Indicators Guide

71. g.Proportion of Outcome Proportion of children Number of U5 % Disaggrega children requiring requiring in-patient care transfers to SC / Total ted by inpatient care number of U5 exits x Refugee 100 and National

72. h.Coverage of Outcome Percentage of expected Number of U5 % CTC (U5) number of severely enrolled at end of the malnourished children month / (Estimated U5 who are enrolled in severe acute CTC malnutrition rate x population U5) x 100

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9.0 Reproductive Health

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

9.0 Reproductive Health • Page 33 Health Information System Standards and Indicators Guide

9.1 Antenatal Care

S/N Indicator Name Type Description Formula Units Standard Source Remarks 73. a. Timing of first Outcome Percentage of first time Number of first time % Antenatal Visit antenatal visits that ANC visits made in were made in first first trimester / trimester Number of first-time ANC visits x 100

74. b. Coverage of Outcome Proportion of ANC Number of pregnant % 100% IAWG RH Syphilis who were women who had been Screening screened for syphilis screened for syphilis during pregnancy during the antenatal period at the time of delivery / Total number of live births x 100 75. c. Prevalence of Impact Percentage of ANC Number of pregnant % IAWG RH Syphilis mothers that tested women tested positive positive on Rapid for syphilis / Total Plasma Reagin testing number of ANC mothers tested x 100

76. d. Abortion ratio Impact Ratio of * to Number of abortions / 1000 live IAWG RH live births in a in the camp / Total births population number of live births in the camp x 1000 * Abortion defined as a spontaneous before 22 weeks gestation

9.0 Reproductive Health • Page 34 Health Information System Standards and Indicators Guide

77. e. Coverage of Outcome Proportion of ANC Number of pregnant % 100% IAWG RH Complete mothers who made at women who had Antenatal Care least 4 antenatal visits made at least 4 during pregnancy antenatal visits at the time of delivery / Total number of live births x 100 78. f. Coverage of Outcome Proportion of ANC Number of pregnant % 100% IAWG RH Tetanus Toxoid mothers who received 2 women who had doses of tetanus toxoid received 2 doses of (TT) vaccine during TT (or were fully pregnancy vaccinated) during the antenatal period at the time of delivery / Total number of live births x 100 79. g. Coverage of Outcome Proportion of ANC Number of pregnant % 100% Intermittent mothers who received 2 women who had Presumptive doses of fansidar (SP) received two doses of Treatment for prophylaxis during SP during the Malaria pregnancy antenatal period at the time of delivery / Total number of live births x 100

9.0 Reproductive Health • Page 35 Health Information System Standards and Indicators Guide

9.2 Delivery Care

S/N Indicator Name Type Description Formula Units Standard Source Remarks 80. i. Crude Birth Rate of live births Number of live births / 1000 10-40 / UNHCR Rate among the population in the camp / Total population / 1000 / population x 1000 month year 81. j. Proportion of Outcome Proportion of births Number of deliveries % 100% IAWG RH Deliveries Births Attended attended by skilled attended by trained are by Skilled Health health worker* health workers / irrespective Worker Number of deliveries of x 100 outcome *Defined as doctors (live or still and/or persons with birth) midwifery skills who can diagnose and manage obstetrical emergencies as well as normal deliveries.

Traditional birth attendants (trained or untrained) are not included 82. k. Proportion of Outcome Proportion of deliveries Number of deliveries % > 15% UN Deliveries Deliveries at at an EmOC facility* in an EmOC facility / Process are EmOC facility Number of deliveries irrespective x 100 of *Health centre includes outcome maternity wards in the (live or still camp and government birth) hospitals define as EmOC facility 83. l. Proportion of Impact Proportion of live births Number of live births % < 15% IAWG RH Low Birth Weight that were less than < 2500g / Number of newborns 2500 g live births x 100

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84. m. Management Impact Proportion of obstetric Number of obstetric % IAWG RH of obstetric complications treated at complications treated UN complications an EmOC facility at an EmOC facility / Process Number of obstetric complications x 100 * Defined as antepartum haemorrhage, post- partum haemorrhage, obstructed labour, pre- eclampsia, eclampsia or puerperal sepsis

85. Stillbirth Rate Impact Rate of still births* in Number of still births / / 1000 total IAWG RH proportion to number of Number of live births births / births and x 1000 month

* Still birth defined as a fetal death after 22 weeks gestation 86. n. Proportion of Outcome Proportion of live births Number of live births % 5 to15% IAWG RH all birth performed by caesarian performed by UN performed by section caesarian section / Process caesarian section Number of live births x 100

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9.3 Postnatal Care

S/N Indicator Name Type Description Formula Units Standard Source Remarks 87. o. Coverage of Outcome Proportion of women Number of women % 100% IAWG RH Complete who received 3 attended for post- Postnatal Care postnatal visits within natal care 3 times six weeks of delivery. within 6 weeks of delivery / Number of live births x 100

9.4 Family Planning

S/N Indicator Name Type Description Formula Units Standard Source Remarks 88. p. Contraceptive Outcome Proportion of women of Number of family % IAWG RH Prevalence Rate reproductive age (15- planning acceptors 49) who are using (or (new and repeat) / whose partner is using) Number of women 15- a contraceptive method 49 years x 100

9.5 Sexual and Gender-based Violence (SGBV)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 89. q. Incidence of Impact Rate at which rapes are Number of rape cases / 10,000 IAWG RH Reported Rape reported in the reported / Total population / MISP population population x 1000 year

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90. r. Timing of ECP Outcome Proportion of rape Number of rape % 100% of Provision survivors who receive survivors who receive eligible emergency ECP within 120 hours rape contraceptive pill (ECP) of an incident / Total survivors within 120 hours of an number of rape cases incident occurring reported 91. s. Timing of PEP Outcome Proportion of rape Number of rape % 100% of IAWG RH Prophylaxis survivors who receive survivors who receive eligible post-exposure PEP within 72 hours rape prophylaxis (PEP) of an incident / Total survivors within 72 hours of an number of rape cases incident occurring reported 92. t. Timing of STI Outcome Proportion of rape Number of rape % 100% of Presumptive survivors who receive survivors who receive eligible Treatment presumptive STI presumptive STI rape treatment within 2 treatment within 2 survivors weeks of an incident weeks of an incident / occurring Total number of rape cases reported

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Health Information System (HIS)

Standards and Indicators Guide

10.0 HIV/AIDS

Note All numerators and denominators refer to one camp over a one month time period. All indicators refer to refugee data only, unless it is specified that National data should be included.

For VCT and PMTCT numerators and denominators, it is assumed that each client progresses consecutively through each stage of counselling and testing (i.e. an individual who is tested for HIV is assumed to have had pre-test counselling; and an individual who is post-test counselled is assumed to have had pre-test counselling and testing.

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10.1 Condom Distribution

S/N Indicator Name Type Description Formula Units Standard Source Remarks 93. a. Condom Outcome Rate of condom Number of condoms / person / 0.5 IAWG RH Distribution Rate distribution among the distributed per month month condoms UNHCR population female) / Total / person / population month

10.2 Voluntary Counselling and Testing

S/N Indicator Name Type Description Formula Units Standard Source Remarks HIV Prevalence Impact Proportion of VCT Number of VCT % Rate (VCT) clients, who were tested clients tested HIV for HIV, who were HIV positive / Number of positive VCT clients tested x 100 94. b. Post test Outcome Proportion of VCT Number of VCT % UNHCR Counseling and clients tested for HIV, clients post-test Result who received post-test counselled / Number result and counselling of VCT clients tested x 100 95. c. Proportional Outcome Proportion of Nationals Number of Nationals % VCT service use who were pre-test pre-test counselled in by Nationals counselled, out of the VCT / Number of VCT total number who were clients pre-test pre-test counseled in counselled (Refugee VCT and National)

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10.3 PMTCT (Antenatal)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 96. d. PMTCT Outcome Proportion of first time Number of first ANC % Coverage Rate ANC visits who were visits pre-test pre-test counselled counselled / Number of first ANC visits

HIV Prevalence Impact Proportion of first ANC Number of first ANC % Rate (PMTCT) visits, who were tested visits tested HIV for HIV, who were HIV positive / Number of positive first ANC visits tested x 100 97. e. Post test Outcome Proportion of first ANC Number of first ANC % UNHCR Counseling and visits tested for HIV, visits post-test Result who received post-test counselled / Number result and counselling of first ANC visits tested x 100 98. f. Post test Outcome Proportion of ANC Number of ANC % Counseling and partners, who were partners post-test Result (ANC pre-test counselled and counselled / Number partners) HIV tested, who of ANC partners received post-test tested x 100 result and counselling 99. g. Proportional Outcome Proportion of Nationals Number of Nationals % PMTCT service who were pre-test pre-test counselled in use by Nationals counselled, out of the PMTCT / Total total number who were number of PMTCT pre-test counseled in clients pre-test PMTCT counselled (Refugee and National)

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10.4 PMTCT (Labour and Delivery)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 100. h. Antiretroviral Outcome Proportion of HIV Number of HIV % Prophylaxis positive mothers who positive mothers who (Mother) swallowed ARV during swallowed ARV labour/delivery during labour/delivery / Total number HIV positive deliveries x 100 101. i. Antiretroviral Outcome Proportion of infants of Number of infants of % Prophylaxis HIV positive mothers HIV positive mothers (Infant) who swallowed ARV who swallowed ARV within 72 hours of within 72 hours of delivery delivery / Total number HIV positive deliveries x 100 102. j. Proportional Outcome Ratio of mother-infant Number of mother- % ARV Use pairs that swallowed infant pairs who (Mother-Infant ARV on time to the swallowed ARV Pair) number of HIV positive according to / deliveries Total number HIV positive deliveries x 100

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10.5 PMTCT (Postnatal)

S/N Indicator Name Type Description Formula Units Standard Source Remarks 103. k. Exclusive Outcome Proportion of HIV Number of HIV % Breastfeeding positive mothers who positive mothers who Rate plan to exclusively plan to exclusively breastfeed after breastfeed / Total delivery number of HIV positive deliveries x 100 104. l. Home-based Outcome Proportion of HIV Number of HIV % Counselling positive mothers who positive mothers who received at least one received at least one home-based home-based counselling visit after counselling visit after delivery delivery/ Total number of HIV positive deliveries x 100 105. m. Family Outcome Proportion of HIV Number of HIV % Planning positive mothers who positive mothers who Acceptance Rate accepted a modern accepted a modern method of family method of family planning after delivery planning after delivery / Total number of HIV positive deliveries x 100 106. n. Co- Outcome Proportion of HIV Number of HIV % trimoxazole positive mothers who positive mothers who Prophylaxis were started on co- were started on co- (mother) trimoxazole prophylaxis trimoxazole prophylaxis / Total number of HIV positive deliveries x 100

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107. o. Co- Outcome Proportion of HIV Number of HIV % trimoxazole positive infants who positive infants who Prophylaxis were started on co- were started on co- (infant) trimoxazole prophylaxis trimoxazole prophylaxis / Total number of HIV positive deliveries x 100 108. Infant HIV Impact Proportion of infants Number of infants % Requires positivity rate born to HIV positive who test positive aged cohort mothers who test 18 months / Total analysis positive for HIV after 18 number of HIV performed months positive deliveries x by HIS 100 database

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