Table 2. Definition of EWIs and their respective performance targets.
| EWI and title | Definition | Numerator | Denominator | Target |
|---|---|---|---|---|
| EWI 1: On-time pill pick-up. | Proportion of patients (adult or children) that pick-up ART no more than two days late at the first pick-up after the baseline pick-up. | Number of patients picking-up their ART “on time” at the first drug pick-up after baseline pick-up date. | Number of patients who picked-up ARV drugs on or after the designated EWI sample start date. | Desirable performance (green): >90%; fair performance (amber): 80–90%; poor performance (red): <80%. |
| EWI 2: Retention in care. | Percentage of adults and children known to be alive and on ART 12 months after initiation. | Number of adults (or children) who are still alive and on ART 12 months after initiating treatment. | Total number of adults or children (excluding transfers out) who initiated ART and were expected to achieve 12-month outcomes within the reporting period. | Desirable performance (green): >85%; fair performance (amber): 75–85%; poor performance (red): <75%. |
| EWI 3: Pharmacy stock-outs. | Percentage of months in a designated year in which there were no ARV drug stock-outs (both for adult and pediatric patients). | Number of months in the designated year in which there were no stock-out days of any ARV drug routinely used at the site. | 12 months of the reporting period. | Desirable performance (green): 100%; poor performance (red): <100%. |
| EWI 4: Pharmacy dispensing practice. | Percentage of patients (adults or children) being dispensed a mono- or dual-ART. | Number of patients who pick up from the pharmacy, a regimen consisting of one or two ARVs. | Number of patients picking up ART on or after the designated EWI sample start date | Desirable performance (green) defined as 0% patients picking-up a mono- or dual-ART; poor performance (red) defined as >0% patients picking-up a mono- or dual-ART. |
| EWI 5: Virological suppression. | Percentage of patients (adult or children) receiving ART at the site after the first 12 months of ART whose viral load is <1000 copies/ml. | Number of patients receiving ART at the site after the first 12 months of ART whose viral load is <1000 copies/ml. | Number of patients at the site who by national policy should have had a viral load performed 12 months after ART initiation. | Desirable performance (green): >85%; fair performance (amber): 70–85%; poor performance (red): <70%. |
EWI, early warning indicator
EWI4 is cross sectional in nature and is intended to assess pharmacy dispensing practices for populations on ART after any period of time on ART.