INDICATOR #3: Percentage of patients officially transferred out to other service sites Rationale Many ART programmes began with a centralised model of care where patients were started on treatment in tertiary care facilities. However, clinics soon became over burdened. As with any other chronic illness, when the patient is stable, they should be sent to lower-level facilities. However, there should be some safety mechanism to ensure that patients who are “down-referred” arrive at the new facility without any treatment interruptions.
Health system indicators
Health Systems Indicator #3: ART therapy and monitoring
Definition of the indicator: numerator and denominator Numerator: Number of people successfully transferred out to other service sites (definition of a “successful” transfer: referred patients that were confirmed to have arrived and been registered at the new service site) Denominator: Number of adults currently on treatment How to calculate the denominator: Add the number of people enrolled in the programme, subtract those who have died, those that were lost to follow-up and those transferred out (we are not interested in numbers of people who were ever enrolled in the programme, only those currently enrolled). Counting those currently enrolled is a more accurate count of your service coverage than is counting those who were ever enrolled (see coverage Indicator #1: ART therapy and monitoring on page 11). Data source ART register
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