Indicator Definitions
Indicator Definitions and Calculations
Indicators are computed from the clean and refinery dbt layers of the MW-PrEP pipeline. This page defines every indicator derived from the MW-PrEP Visit Log v3.2, including its numerator, denominator, disaggregation, and source variables.
Note
Indicator definitions follow PEPFAR MER 2.7 and Malawi Ministry of Health PrEP programme protocols where applicable. Deviations from standard definitions are noted explicitly under each indicator. All indicators exclude records with at least one DQA Error in the clean dataset unless otherwise noted.
Routine Indicators
Standard indicators reported to PEPFAR and the Malawi Ministry of Health on a monthly or quarterly basis.
Detailed Definitions
PrEP New
| Field | Value |
|---|---|
| Full name | PrEP New — Individuals initiating PrEP for the first time |
| Short name | PrEP_NEW |
| Definition | Count of individuals who received PrEP for the first time during the reporting period, recorded as a first assessment in the PrEP Register. |
| Numerator | COUNT(*) where prep_initiation = 1 AND register_prep_reg_type = 'first assessement' |
| Denominator | N/A |
| Disaggregation | sex_pepfar, agegroup_pepfar, location_name, district, quarter_pepfar |
| Inclusion criteria | Records with a linked PrEP Register entry; visit date on or after site activation date. |
| Exclusion criteria | Records with DQA Error severity; transfer-in registrations; reassessments. |
| Reporting frequency | Quarterly (PEPFAR MER) |
| Source variables | prep_initiation, register_prep_reg_type, sex_pepfar, agegroup_pepfar, quarter_pepfar, location_name |
| Reference | PEPFAR MER 2.7 § PrEP_NEW |
Transfer-in clients (register_prep_reg_type = 'transfer in') are excluded from PrEP_NEW and counted separately. Reassessments (register_prep_reg_type = 'reassessment') are also excluded. The prep_initiation_flag column in the source model documents edge cases in cohort construction.
PrEP Continuing
| Field | Value |
|---|---|
| Full name | PrEP Continuing — Clients continuing PrEP in the reporting period |
| Short name | PrEP_CT |
| Definition | Count of individuals who received at least one PrEP visit during the reporting period and had previously initiated PrEP (i.e. not a new initiate). |
| Numerator | COUNT(*) where prep_visit = 1 AND register_prep_reg_type != 'first assessement' |
| Denominator | N/A |
| Disaggregation | sex_pepfar, agegroup_pepfar, location_name, district, quarter_pepfar |
| Inclusion criteria | Must have a prior PrEP initiation record; visit outcome = start/continue. |
| Exclusion criteria | Records with DQA Error; first-assessment visits; defaulters without a return visit in period. |
| Reporting frequency | Quarterly (PEPFAR MER) |
| Source variables | prep_visit, register_prep_reg_type, sex_pepfar, agegroup_pepfar, quarter_pepfar |
| Reference | PEPFAR MER 2.7 § PrEP_CT |
The prep_visit_flag column documents records with ambiguous visit classification. Defaulters who return within the same reporting quarter are counted as continuing.
PrEP Visit
| Field | Value |
|---|---|
| Full name | Total PrEP visits in reporting period |
| Short name | PrEP_VISIT |
| Definition | Total number of valid PrEP client visit records in the reporting period, regardless of registration type or outcome. |
| Numerator | COUNT(*) where prep_visit = 1 |
| Denominator | N/A |
| Disaggregation | sex_pepfar, agegroup_pepfar, delivery_point_name, location_name, district, month_calendar |
| Inclusion criteria | All valid, non-discarded visit records with a parseable visit date. |
| Exclusion criteria | DQA Error records; discarded rows; implementation error rows. |
| Reporting frequency | Monthly |
| Source variables | prep_visit, visit_card_visit_date, delivery_point_name, location_name |
| Reference | Malawi MoH PrEP programme protocol |
PrEP Outcome: Continuing at Facility
| Field | Value |
|---|---|
| Full name | PrEP clients continuing at facility — visit outcome |
| Short name | PrEP_CONT |
| Definition | Number of visits where the recorded outcome was start/continue PrEP at this facility. |
| Numerator | COUNT(*) where outcome = 'start/continue prep at facility' (column: prep_here) |
| Denominator | N/A |
| Disaggregation | sex_pepfar, agegroup_pepfar, location_name, district, month_calendar |
| Inclusion criteria | Valid visit records only. |
| Exclusion criteria | DQA Error records. |
| Reporting frequency | Monthly |
| Source variables | prep_here, outcome, visit_card_visit_date, location_name |
| Reference | Malawi MoH PrEP programme protocol |
PrEP Outcome: Stop PrEP
| Field | Value |
|---|---|
| Full name | Clients stopping PrEP — by stop reason |
| Short name | PrEP_STOP |
| Definition | Number of clients who discontinued PrEP during the reporting period, disaggregated by reason for stopping. |
| Numerator | COUNT(*) where prep_outcome is in stop categories: noprep_refuse, noprep_side_effect, noprep_low_risk, noprep_hiv_positive, noprep_hiv_positive_outcome |
| Denominator | N/A |
| Disaggregation | stop_reasons, sex_pepfar, agegroup_pepfar, location_name, district, month_calendar |
| Inclusion criteria | Valid visit records with a stop outcome. |
| Exclusion criteria | DQA Error records. |
| Reporting frequency | Monthly |
| Source variables | stop_reasons, noprep_refuse, noprep_side_effect, noprep_low_risk, noprep_hiv_positive, visit_card_visit_date |
| Reference | Malawi MoH PrEP programme protocol; PEPFAR MER 2.7 |
Stop reasons map directly to the visit_outcome bubble options on the physical form. The stop_reasons_flag column documents invalid or multi-selected stop reason combinations.
HIV Seroconversion on PrEP
| Field | Value |
|---|---|
| Full name | HIV seroconversion while on PrEP |
| Short name | HIV_SEROCONV |
| Definition | Number of PrEP clients who tested HIV positive during a follow-up visit while enrolled in PrEP, indicating a seroconversion event. |
| Numerator | COUNT(*) where hiv_seroconversion = 1 |
| Denominator | N/A |
| Disaggregation | prep_type_when_seroconverted, hiv_seroconversion_on_cab_la, location_name, district, seroconversion_follow_up_month |
| Inclusion criteria | Clients with a prior clean PrEP initiation record; HIV positive outcome confirmed in visit record or HTS initial register. |
| Exclusion criteria | Clients already HIV positive at initiation; DQA Error records. |
| Reporting frequency | Monthly |
| Source variables | hiv_seroconversion, hiv_seroconversion_on_cab_la, prep_type_when_seroconverted, seroconversion_follow_up_month |
| Reference | Internal programme protocol; PEPFAR MER 2.7 |
The hiv_seroconversion_flag column marks records with ambiguous seroconversion status (e.g. missing HIV result, or HIV positive outcome without a confirmed test date). Seroconversions on CAB-LA are separately tracked via hiv_seroconversion_on_cab_la.
CAB-LA Initiation
| Field | Value |
|---|---|
| Full name | Cabotegravir LA injectable PrEP — new initiates |
| Short name | CABLA_INIT |
| Definition | Number of clients starting injectable PrEP (Cabotegravir LA) for the first time during the reporting period. |
| Numerator | COUNT(*) where cab_la_registration = 1 AND register_prep_reg_type = 'first assessement' |
| Denominator | N/A |
| Disaggregation | sex_pepfar, agegroup_pepfar, cab_la_enrolment_type, location_name, district, quarter_pepfar |
| Inclusion criteria | Valid PrEP Register and Visit Card/Log linked records; CAB-LA prescribed and injection given. |
| Exclusion criteria | Oral-only initiates; clients switching from oral to CAB-LA (counted separately as started_cab_after_first_visit); DQA Error records. |
| Reporting frequency | Quarterly |
| Source variables | cab_la_registration, cab_la_enrolment_type, started_cab_first_visit, register_prep_reg_type |
| Reference | PEPFAR MER 2.7; Malawi MoH CAB-LA rollout protocol |
Clients switching from oral PrEP to CAB-LA after first visit are tracked via started_cab_after_first_visit. The cab_la_specific_registration_flag column identifies records with ambiguous CAB-LA registration status.
CAB-LA Continuation
| Field | Value |
|---|---|
| Full name | Cabotegravir LA injectable PrEP — continuation |
| Short name | CABLA_CONT |
| Definition | Number of CAB-LA clients returning for continuation injections, disaggregated by continuation timing status (on time, late, defaulted). |
| Numerator | COUNT(*) where cab_la_continuation is non-null and non-empty |
| Denominator | N/A |
| Disaggregation | cab_la_continuation_status, cab_la_continuation_timing, cab_la_follow_up_month, location_name, district |
| Inclusion criteria | Clients with at least one prior CAB-LA visit. |
| Exclusion criteria | Clients who stopped CAB-LA; DQA Error records. |
| Reporting frequency | Monthly |
| Source variables | cab_la_continuation, cab_la_continuation_status, cab_la_continuation_timing, cab_la_follow_up_month, master_registration_date |
| Reference | PEPFAR MER 2.7; Malawi MoH CAB-LA rollout protocol |
Follow-up months are calculated from the master registration date. The cab_la_continuation_flag documents records where continuation status cannot be determined.
PEPFAR CAB-LA New and Returning Clients
| Field | Value |
|---|---|
| Full name | PEPFAR — Clients initiated on CAB-LA and returning within one month |
| Short name | PEPFAR_CABLA |
| Definition | PEPFAR standard counts: (1) total clients initiated on CAB-LA; (2) clients returning for second visit within one month; (3) clients returning for any visit within one month. |
| Numerator | total_clients_initiated_on_cabla; total_clients_returning_in_one_month_second_visit; total_clients_returning_in_one_month_any_visit |
| Denominator | N/A |
| Disaggregation | report_end_date |
| Inclusion criteria | All valid CAB-LA initiation records. |
| Exclusion criteria | DQA Error records. |
| Reporting frequency | Quarterly |
| Source variables | total_clients_initiated_on_cabla, total_clients_returning_in_one_month_second_visit, total_clients_returning_in_one_month_any_visit, report_end_date |
| Reference | PEPFAR MER 2.7 § PrEP_NEW (CAB-LA sub-indicator) |
Custom Indicators
Programme-specific indicators not part of the standard PEPFAR or MoH reporting framework but used for operational monitoring and programme management.
Programme Cascade Indicators
These indicators together describe the PrEP care cascade and are used for high-level programme performance reviews.
| MW-PrEP Care Cascade — Indicator Steps | |||
| Step | Cascade Stage | Source Column | Definition |
|---|---|---|---|
| 1 | Initial PrEP Screening | initial_prep_screening | Client presented for initial PrEP eligibility screening. |
| 2 | PrEP Eligible | initial_prep_eligible | Client assessed as eligible for PrEP initiation. |
| 3 | PrEP Initiation | prep_initiation | Client initiated PrEP (first visit with prescription). |
| 4 | PrEP Registration | prep_registration | Client registered in the PrEP Register. |
| 5 | PrEP Visit (Follow-up) | prep_visit | Client attended at least one follow-up PrEP visit. |
| 6 | PrEP Outcome Recorded | prep_outcome | A visit outcome was recorded (continuing, transferred, stopped). |
| 7 | CAB-LA Registration | cab_la_registration | Client registered as a CAB-LA client. |
| 8 | CAB-LA Visit | cab_la_visit | Client attended a CAB-LA injection visit. |
| 9 | CAB-LA Continuation | cab_la_continuation | Client returned for continuation injection on schedule. |
All cascade steps are available in mw_prep__program_indicators_report as the indicator / value / flag array-joined columns. Steps 7–9 are only populated for clients enrolled on CAB-LA.
DQA Flag Handling
Warning
Records with DQA Errors are excluded from all indicator calculations by default. The table below documents which specific DQA checks affect which indicators and how.
| DQA Flags and Their Effect on Indicators | ||
| DQA Check | Indicators Affected | Effect |
|---|---|---|
| prep_reg_id missing | All indicators | Record excluded from numerator and denominator — no PrEP ID means no cohort linkage possible. |
| PrEP ID mod-223 transcription error | All indicators using prep_reg_id linkage | Record excluded unless orphan matching finds a verified alternative — indicated by orphaned-matching-suggestion tag. |
| HTS Link ID Damm transcription error | Sex-age mismatch rate; HIV seroconversion; Cross-register sex consistency checks | Record excluded from cross-register linked indicators; included in non-linked indicators. |
| visit_date invalid or out of range | All time-series indicators (PrEP_VISIT, PrEP_NEW, PrEP_CT, monthly summaries) | Record excluded from numerator — cannot be assigned to a reporting period. |
| appointment_date invalid or before visit_date | Upcoming appointments; Clients late for appointment; Defaulters | Record excluded from appointment schedule — next visit date cannot be computed. |
| Sex/Pregnancy multi-select or missing | All sex-disaggregated indicators (PrEP_NEW, PrEP_CT, PEPFAR summary) | Record excluded from sex-disaggregated numerators; counted under missing/invalid sex category. |
| Visit Outcome multi-select or missing | PrEP_STOP, PrEP_CONT, PrEP Transfer Out, HIV seroconversion, Missing appointment date for continuing client | Record excluded from outcome-based indicators; cannot be assigned a stop reason or continuation status. |
| PrEP option multi-select or missing | CAB-LA Initiation, CAB-LA Continuation, PrEP Dispensed, Oral PrEP intention indicators | Record excluded from regimen-based indicators; counted under prescribe__invalid or prescribe__missing. |
| Age invalid integer | All age-disaggregated PEPFAR indicators | Record excluded from age-band numerators; counted under age__invalid. |
| HIV positive client prescribed PrEP | PrEP_NEW, PrEP_CT, CAB-LA Initiation | Record excluded from all active-prescription indicators as clinically ineligible. |
| PrEP not prescribed but continued at facility | PrEP_CT, PrEP_CONT | Record excluded — outcome and prescription are contradictory; cannot be counted as continuing. |
| Multiple visit entries same day | PrEP_VISIT, PrEP_CT, all time-series counts | Duplicate records excluded — only one visit per client per date is counted. |
| PrEP ID not unique | All indicators aggregated by prep_reg_id | Affected records flagged; excluded from cohort-level indicators until resolved. |
| HIV positive client has subsequent visit | PrEP_CT, CAB-LA Continuation, active client status | Post-seroconversion visits excluded from active PrEP continuation counts. |
| Missing appointment date for continuing client | Upcoming appointments; Clients late for appointment; Defaulters | Record cannot enter the appointment tracking pipeline; excluded from scheduling indicators. |
| PrEP register not linked | All indicators requiring register–visit card join (PrEP_NEW, sex consistency, age consistency) | Record treated as orphan; excluded from linked indicators; included in orphan rate calculation. |
| CAB-LA injection inconsistency | CAB-LA Initiation, CAB-LA vial inventory reconciliation | Warning only — record retained but flagged; highlighted in DQA dashboard for clinical review. |
Generated automatically from MW-PrEP Visit Log v3.2 source files. Last updated: 2026-06-09.