This document discusses key concepts for analyzing public health programs, including setting targets, calculating coverage and retention, and common analyses. It defines indicators, targets, coverage, and retention. It provides approaches for setting overall and annual targets, such as using past performance or local high performers. Coverage is calculated by comparing service utilization or availability to the target population. Retention examines if clients receive the full package of services. Calculating these metrics helps programs monitor progress, resource needs, and understand how well they are serving the target population.

1. Module 2:
Basic analyses

2. Module 2: Learning Objectives
 Identify approaches for setting targets
 Understand common analyses that calculate
program coverage and retention
 Calculate program coverage and retention

3. Terminology
 Indicator
 Target
 Program coverage
 Service availability
 Service utilization
 Program retention

4. Indicator
 Program element that needs tracking
 Measures an aspect of a program’s performance
 Measures changes over a period of time
• # of new family planning users
• # of clients currently on ART
 Expressed as a number or percentage

5. Target Definition
 A specified level of performance for a
measure (indicator), at a predetermined
point in time (i.e., achieve ‘x’ by ‘y’ date)
 Overall target
 Annual targets

6. Why Set Targets?
 Targets help program staff with:
 Planning
– Staffing and service delivery
– Commodities
 Monitoring progress
– Break long-term goals into manageable pieces
– Check progress on indicators

7. Setting Reasonable Targets
 The range of values for a given indicator
can be from 0% to 100%.
• Example: The theoretical range for the Polio
indicator is between 0% of children
immunized (bad) and 100% immunized
(ideal)
• Is it appropriate to set the Polio indicator
target at 100% for a given program?
Why/why not?

8. Setting Reasonable Targets
 Example: In Somalia, the national CPR from
2007 to 2009 was15%. The following year, a
national target was set for 70%.
 Is it appropriate to set the CPR target for
Somalia at 70%? Why/why not?

9. Overall Target Setting Approaches
 There are three approaches to set a target :
 Established long-term goals by contacting that
national program
 Past performance (of your program, increasing by
no more than 10%)
 Local high performer (a stellar program nearby)
 Consider the number of clients your program can
realistically expect to serve during a given period
of time

10. Annual Target Setting
 Determine the increase your program needs
to gain to reach your overall target
 Divide that number by the number of years in
which you would like to achieve the target
 Add the number to your baseline indicator for
each year

11. Considerations for Target Setting
 Ensure you have an agreed-upon and realistic
definition of target population
 Set a realistic target to achieve in the long term
and short term

12. Importance of Defining the Target
Population: Case Example
 Target was 372 children to be immunized
 Actual was 488 children immunized
 To calculate the % target achieved, use
(Actual/Target) * 100
 488/372 = 1.31*100 = 131%
 How could the clinic have surpassed its
target by so much?

13. Implications of Incorrect Target
Setting: Case Example
 You don’t really know to what extent you’re fully
immunizing the children in your setting
 If your program purchases commodities (e.g.,
vaccines) based on the target set, supply could
run out
 If you set your target too low, you may not have
enough vaccines, leading to disease outbreaks

14. Common Analyses
 Program Coverage
 Extent to which a program reaches its intended
target population, institution, or geographic area
 Compare current performance to prior year/quarter
 Compare performance between sites
 Program Retention
 Extent to which the range of services is being
delivered as initially intended so that client drop-
outs are minimal

15. 15
Why do we need to measure
coverage?
 To understand program progress
 To determine if the target is reached
 Clients, commodities, adherence…
 To determine if one target is reached more
effectively than another
• Are there underserved area/regions, subpopulations?

16. Program coverage
 Extent to which a program reaches its intended target
population, institution, or geographic area
 Utilization:
 Is the target population utilizing services, accessing
commodities, being reached with services?
 Availability:
 Are the services available where there is a need?

17. Utilization calculation
Percentage of the target population utilizing
services
# of individuals in target population
using a service
------------------------------------------- X 100
# of individuals in target population

18. Utilization calculation: Example
 No. of persons educated as of 6/12/09 = 300
 Goal for 12/31/09 = 900
300
900
 You have reached 33% of your target group with
education messages
= 0.33 x 100 =
33%

19. Comparison of time periods
 Compare percentage achieved toward target for
different time periods, different sites, etc.
 Rate of increase
 As of January, 70 people educated; by June, 300
people
 300 – 70 = 230 increase in people educated
 230/6 = 38.3 new people educated per month
over the 6 months

20. Sought prenatal care
(600)
All pregnant women
(2,000)
PMTCT
Target
(1,000)
Utilization =
Service users
Target population
Counseled &
Tested for HIV (500)
Utilization of PMTCT Programs
Utilization =
600/1,000 = 0.6
0.6 x 100 = 60%

21. Program coverage
 Extent to which a program reaches its intended target
population, institution, or geographic area
 Utilization:
 Is the target population utilizing services, accessing
commodities, being reached with services?
 Availability:
 Are the services available where there is a need?

22. Availability calculation
 Number of service outlets available per target
population
 # of clinics with PMTCT per # of pregnant women
 Expressed as a ratio

23. PMTCT clinic availability
 There are 8 clinics offering PMTCT & 100,000
pregnant women in region X.
 Ratio of clinics to pregnant women 8:100,000
 Reduce to (1:12,500) pregnant women
 The standard recommendation is 1 clinic with
PMTCT services per 10,000 pregnant women
 Clinic availability is not reaching the target

24. Availability + Utilization = Coverage
 Service availability is 1:12,500
 Service availability target is 1:10,000
 PMTCT service utilization is 25% off the target
 What can we conclude?
 Service availability and utilization are too low; the
program is not meeting the needs of pregnant
women.

25. 25
Program retention
 Measures if the range of services are being delivered
as initially intended
 Determines program retention, i.e., is the project
keeping clients through entire package of services?
• Important in clinical programs where drug adherence is
an issue (TB, HIV/AIDS, immunization) and there are
multiple steps (PMTCT)

26. Utilization
Retention example: Immunization
Enter service
Polio dose 1
Polio dose 2 Polio dose 3
Completion

27. Tested for HIV (500)
Sought prenatal care (600)
All pregnant women
(2,000 women)
PMTCT
Target
(1,000)
40 received
prophylaxis
350 received HIV-
result or no result
100 received HIV+
result
PMTCT Program Retention

28. Tested for HIV
Sought prenatal care
All pregnant women
(2,000 women)
40 received
prophylaxis
350 received HIV-
result
100 received HIV+
result
1,000
500
PMTCT Program Retention

29. Tested for HIV (500)
Sought prenatal care (600)
All pregnant women
(2,000 women)
PMTCT
Target
(1,000)
40 received
prophylaxis
350 received HIV-
result
100 received HIV+
result
PMTCT Program Retention

30. Tested for HIV (500)
Sought prenatal care (600)
All pregnant women
(2,000 women)
PMTCT
Target
(1,000)
40 received
prophylaxis
350 received HIV-
result or no result
100 received HIV+
result
PMTCT Program Retention

31. Tested for HIV (500)
Sought prenatal care (600)
All pregnant women
(2,000 women)
PMTCT
Target
(1,000)
40 received
prophylaxis
350 received HIV-
result or no result
100 received HIV+
result
PMTCT Program Retention

32. Key messages
 Target Setting – A specified level of performance for
a measure (indicator) at a predetermined point in
time. Both overall and annual targets are set
 Coverage – extent to which a program reaches
its intended target population, institution, or
geographic area
 Retention – the extent to which the range of
services are being delivered as initially intended,
with clients retained throughout the full package
of services