The purpose of the SRHR and HIV Linkages Index is to measure the extent to which SRHR and HIV responses are linked and provide the first ever composite score, in order to:
- track progress of how well a country is doing at linking SRHR and HIV;
- increase understanding of SRHR and HIV linkages;
- support advocacy for improved linkages;
- deepen knowledge on the drivers and effects of SRHR and HIV linkages; and
- highlight data gaps which need to be filled.
Below is a brief overview of the methodology. A more detailed description of the methodology is available on request.
Development process: The Index development process started in September 2014 and was initiated by UNFPA, WHO and IPPF. To ensure the Index is statistically sound, the Institute for Economics and Peace were commissioned to lead the statistical development of the Index. Development was supported by a panel of experts in the field of SRHR and HIV Linkages – including several M&E experts – was convened and included government representatives (Government of Zimbabwe), global donors (USAID and the Global Fund to Fight AIDS, TB and Malaria), UN Agencies (UNFPA, WHO, UNAIDS), civil society organisations (IPPF, FHI360, Population Council, ICAP) and networks of people living with HIV (ICW, GNP+).
Country selection: 60 countries were chosen for inclusion in the Index. These were countries that fulfilled at least one of the following criteria:
- had completed the Rapid Assessment Tool for SRH and HIV Linkages;
- were a priority country for PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Indicators and data sources: The SRHR and HIV Linkages Index, has been constructed using 30 indicators across the three domains. A full list of the indicators, sources, and targets are available to download here. Data were primarily collected directly from open web-based sources such as the AIDSInfo Online Database, DHS Stat Compiler and the WHO Global Health Observatory Data Repository. Where data were not available online, they were coded from reports or provided directly from UN Agencies such as UNAIDS, WHO and UNFPA. The data used were the latest data available between 2008 and 30 April 2016.
Scoring system: The Index uses a goal-based scoring system rather than a relative or absolute one. Therefore, the scores given for each indicator represent progress towards an explicit target. Where possible, global targets have been used. For example, the target for HIV treatment coverage is 90% so if a country scores 90% or above, it receives a maximum score for this indicator. When no global strategy was available for guidance, a target for the indicator was set following discussions by the expert panel. As the scoring system is goal-based it means that over time, the SRHR and HIV Linkages Index can act as an aspirational tool and be used to track progress towards a fully linked SRHR and HIV response.
Weighting: Each indicator in the SRHR and HIV Linkages Index is equally weighted, with no additional weighting at the domain level. It is noted that as the number of indicators in each domain is not the same, domains with a greater number of indicators comprise a larger proportion of the final score.
Data availability: Overall data availability was 81.7%. When data were unavailable, values were imputed using a nearest-neighbour methodology. As the Index is a measure of how close a country is to achieving the goal of SRHR and HIV linkages, no composite score was calculated for countries with less than 65% data coverage since, in the opinion of the expert steering group, having lower data coverage than this would produce scoring ranges too broad to be useful. Setting the cut-off at this level reduced the number of countries from 60 to 58. Additionally, the same cutoff criteria were applied to each individual domain score. Countries are therefore not ranked sequentially from highest to lowest in the index but instead the results are displayed in 10% (decile) bands.