Table 2.

Proposed scorecard of program-level quality measures

STEP ALONG CONTINUUM	MEASURE
a) HIV Testing and Diagnosis	▪% of patients diagnosed on site [P]
	▪% of patients diagnosed in other medical facilities [P]
	▪% of patients diagnosed via home-based test [P]
	▪% of patients diagnosed in mobile testing unit [P]
	▪% of couples whose partners have been HIV tested and are aware of results [P]
b) Linkage to Care	▪ Median days from HIV diagnosis to referral for ART or pre-ART care [P]
	▪% of patients ART ineligible at baseline who receive a follow-up CD4 count in 6 months [P]
	▪ Median days from clinic enrollment to ART eligibility [P]
	▪% of patients who are enrolled in HIV clinic, received CD4 count & results within 3 months of HIV diagnosis [P]
	▪% of patients with CD4 count ≤ 200 cells/uL, & ≤ 350 cells/uL at presentation [P]
c) ART Eligibility: Clinical, Laboratory & Psychosocial Assessment	▪% of patients screened for tuberculosis [P]
	▪% of eligible patients provided with nutritional supplementation [P]
	▪% of ART-eligible patients who died before ART initiation [O]
d) ART Preparation: Literacy Training, OI Prophylaxis, and Adherence Assessment	▪ Median days from enrollment to ART initiation for eligible patients [P]
	▪ Median days from enrollment to completion of ART literacy training for eligible patients [P]
e) ART Initiation	▪ # drug stock outs in last quarter for first-line ART drugs or cotrimoxazole [P]
	▪ Local guideline concordance (e.g. CD4 testing, adherence monitoring, assessment for drug toxicity, OI screening & prophylaxis) [P]
f) Retention in Care	▪% of patients retained in care 6 and 12 months from enrollment (ART eligible and ART-ineligible) [O]
	▪% of patients who transferred care to other clinics 6 and 12 months from enrollment [O]
	▪% of patients deemed lost to follow-up who have been contacted by clinic staff to determine outcome [O]
g) Clinical Outcomes	▪% of patients on ART with undetectable viral load at 12 months [O]
	▪% of patients on ART requiring switch to second-line therapy for treatment failure at 12 and 24 months [O]
	▪% of patients (ART-eligible on and off ART) who died 12 months after enrollment [O]
h) Patient Reported Outcomes	▪ patient-reported health status 6 and 12 months after clinic enrollment [O]

[P] = process measure, [O] = outcome measure.