National evaluators identify at least two respondents to be interviewed for each component in order to corroborate the answers. Evaluators are directed to conduct personal, individual, or small group interviews to ensure that the items on the questionnaire are well understood and to maximize accuracy and completeness. The average recommended interview time per respondent ranges from 30 to 60 minutes and responses are not linked to the individual respondents in order to maintain confidentiality. Expert respondents are encouraged to respond to only those items and components of the questionnaire about which they feel sufficiently knowledgeable.  After completing all interviews for a country, each national evaluator combines the responses from all interviews into a single summary response and can use their discretion in recording majority, consensus responses or responses that best describe the national AIDS program.

Data Source(s):

Interviews with expert respondents who have been carefully selected for their professional and in-depth knowledge in the ten component areas.

Purpose:

Developed measure program effort in response to the HIV/AIDS epidemic, the API is designed to provide a current profile of national effort and a measure of change over time (UNAIDS/USAID/POLICY, 2001).  The term ‘national’ refers to all domestic inputs including central, regional, and local by both government and NGOs. The API was applied to 40 countries in 2000 and a revised index was applied in 54 countries in early 2003 (USAID et al., 2003). At the global level, an effort score can be used to analyze the independent contribution of program effort to program success in a variety of social and cultural settings. At the country level, an effort score can be used as a diagnostic tool to indicate the strength and weaknesses of various program areas and to suggest corrective action. In terms of evaluation and impact, the API can be used to determine the effects of national and international efforts on outcomes.  Although the API scores are not intended to rank or grade countries on their effort, the scores are useful as profiles, which can be used to indicate to international agencies and donors where past efforts have led to improvements and where greater emphasis may be required in the future.

Issue(s):

The API is intended to measure the effort put into HIV prevention and care. It does not measure the socioeconomic context of the epidemic and response nor does it measure the outcomes.  The API scores are based on responses that are a mixture of fact and subjective judgment. On the subjective items, respondent expectations may play a role in their assessments. The extent to which these expectations can vary across countries affect the usefulness of the scores for international comparisons. More objective scores could be developed from the subset of API items that are the least subject to respondent judgment, however, these scores would not provide a rich picture of overall program effort.  The process of collecting and reporting the data for the API is very labor intensive, with only two primary rounds (1998-2000 and 2003) having been conducted to date.

References:

Global Health.Gov Website, 2008, National Composite Policy Index Questionnaire, Washington, D.C.: U.S. Department of Health and Human Services, PEPFAR, 2009, http://www.globalhealth.gov/news/news/072908b.html