Indicator name Numerator Denominator Indicator Routine Data
Elements Data Element Guide for use and Context
1 Utilisation rate - PHC PHC total headcount Total
population The rate at which PHC services are utilised by the catchment population, represented as the average number of visits per person per year in the catchment population. The denominator is usually Census-derived population estimates.
USE: To determine overall utilisation patterns, in particular relevant for the move towards equity in the health sector.
COMMENTS Utilisation may depend on many things like accessibility, acceptance and appropriateness of services, as well as the legacy of apartheid with its gross inequities in resources and personnel.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/ home) are included in total headcount.
2 Utilisation rate under 5
years - PHC PHC headcount under 5 years Population under 5 years The rate at which PHC services are utilised by clients 5 years and older in the catchment population, represented as the average number of PHC visits per year per person 5 years or older in the catchment population. The denominator is usually Census-derived population estimates.
USE To determine overall utilisation patterns, in particular relevant for the move towards equity in the health sector.
COMMENTS Utilisation may depend on many things like accessibility, acceptance and appropriateness of services.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
3 Utilisation rate 5 years
and older - PHC PHC headcount 5 years and older Population 5 years and older
The rate at which PHC services are utilised by children under 5 years in the catchment population, represented as the average number of PHC visits per child under 5 per years in the target population. The denominator is usually Census-derived population estimates. USE To determine overall utilisation patterns, in particular relevant for the move towards equity in the health sector.
COMMENTS Utilisation may depend on many things like accessibility, acceptancey and appropriateness of services.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/ home) are included in total headcount.
Primary Health Care Facility Supervision Manual
4 Proportion of PHC
headcount seen between 7pm and 7am
PHC headcount seen between 7pm and 7am
PHC total
headcount The percentage of all PHC visits that are seen between 7pm in the evening and 7am in the morning, often referred to as `after hours`.
PHC headcount seen between 7pm and 7am
All individual patients attending the facility between 7pm (19.00) and 7am (07.00) for Primary Health Care (this includes Emergency care as well as deliveries) during the reporting period. Each patient is counted once for each day they appear regardless of the number of services utilised during the visit.
This period is often loosely referred to as `after hours`, but that term is not clear. Note that only patients seen after 19.00 and before 07.00 in the morning should be counted.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/ home) are included in total headcount.
5 Child under 5 years
case load - PHC PHC headcount under 5 years PHC total headcount Children under 5 years headcount as a percentage of PHC total headcount. USE Using more detailed studies on requirements for child care (time, services, equipment), this indicator can be used both to allocate resources and to `weigh` workload figures between facilities and health districts. COMMENTS This indicator must not be confused with `Child Utilisation Rate`, which indicates extent of children utilising the facility (or to what extent services are reaching children in the area).
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/home) are included in total headcount.
6 Professional Nurse
clinical work load - PHC PHC total headcount Professional Nurse clinical workdays
The average number of patients seen per Professional Nurse per clinical workday. PHC total headcount is used as a proxy numerator.
Nurse work loads are relevant for analysing utilisation patterns, efficiency, need for more/less staff, more training, etc.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount
5 years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/home) are included in total headcount.
Professional Nurse clinical workdays
The number of actual workdays by Professional Nurses, irrespective of rank, used to perform clinical services in the facility during the reporting period (usually month). One actual work day is normally equivalent to an 8-hour shift (40 hours).
Do not confuse this data element with `Clinical days open during month` since the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues.
7 Enrolled Nurse clinical
work load - PHC PHC total headcount Enrolled Nurse clinical
workdays
The average number of patients seen per enrolled nurse per clinical workday. PHC total headcount is used as a proxy numerator.
Nurse work loads are relevant for analysing utilisation patterns, efficiency, need for more/less staff, more training, etc.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/home) are included in total headcount.
Enrolled Nurse
clinical workdays The number of actual workdays by Enrolled Nurses, irrespective of rank, used to perform clinical services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours).
Do not confuse this data element with `Clinical days open during month`, as the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues.
8 Nursing Assistant
clinical work load - PHC PHC total headcount Nursing Assistant clinical workdays
The average number of patients seen per Nursing Assistant per clinical workday. PHC total headcount is used as a proxy numerator.
Nurse workloads are relevant for analysing utilisation patterns, efficiency, need for more/less staff, more training, etc.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/ home) are included in total headcount.
Nursing Assistant
clinical workdays The number of actual workdays by Nursing Assistants used to perform clinical services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours of work per week).
Do not confuse this data element with `Clinical days open during month`, since the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues.
Primary Health Care Facility Supervision Manual
9 Pharmacy staff clinical
work load - PHC PHC total headcount Pharmacy staff clinical
workdays
The number of patients seen per pharmacy staff member per clinical workday. PHC total headcount is used as a proxy numerator.
Pharmacy workload is relevant for analysing utilisation patterns, efficiency, need for more/less staff, more training, etc. Note that pharmacy staff can be pharmacists, pharmacy assistants, or other clinical staff like nurses working full-time with dispensing drugs. CONTEXT: Equitable workload is important for both staff and patients.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/ home) are included in total headcount.
Pharmacy staff
clinical workdays The number of actual workdays by Pharmacy staff, irrespective of rank, used to perform pharmacy services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours).
Include the working days for all pharmacy staff who are involved in processing prescriptions, or in other words involved with the `clinical` side, whether these are qualified pharmacists or not. CONTEXT: Workload indicators and monitoring.
10 Nurse clinical work load
- PHC PHC total headcount Nurse clinical workdays The number of patients seen per nurse per clinical workday. Doctor workloads are relevant for analysing utilisation patterns, efficiency, need for more/ less staff, more training, etc. CONTEXT: Equitable workload is important for both staff and patients.
PHC headcount
under 5 years All individual patients not yet reached five years (60 months) of age attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Include any child given individual service(s) during e.g. a home or crèche visit.
CONTEXT: Workload indicators and monitoring of facility utilisation and accessibility.
PHC headcount 5
years and older All individual patients five years (60 months) and older attending the facility during the reporting period (usually month) for Primary Health Care. Each patient is counted once for each day they appear at the facility, regardless of the number of services utilised during the visit.
Only the mother is counted with regard to a delivery. DOTS visits to the facility (NOT DOTS in community/workplace/home) are included in total headcount.
Professional Nurse clinical workdays
The number of actual workdays by Professional Nurses, irrespective of rank, used to perform clinical services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours).
Do not confuse this data element with `Clinical days open during month` - the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues. Enrolled Nurse
clinical workdays The number of actual workdays by Enrolled Nurses, irrespective of rank, used to perform clinical services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours).
Do not confuse this data element with `Clinical days open during month`, since the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues.
Nursing Assistant
clinical workdays The number of actual workdays by Nursing Assistants used to perform clinical services in the facility during the reporting period (usually month). One actual workday is normally equivalent to an 8-hour shift (40 hours of work per week).
Do not confuse this data element with `Clinical days open during month`, as the two would only be equal when there is only ONE nurse in the facility. Only days PRIMARILY used to handle patients are included, NOT days primarily used for e.g. training courses, meetings and other administrative issues.
11 Doctor clinical work
load - PHC PHC case seen by doctor Doctor clinical workdays The number of patients seen per doctor per clinical workday. Doctor workloads are relevant for analysing utilisation patterns, efficiency, need for more/ less staff, more training, etc. CONTEXT: Equitable workload is important for both staff and patients.
PHC case seen by
doctor – referred A patient/client (child or adult) seen by a doctor for a Primary Health Care curative service (diagnosis and treatment), after the patient/client had been seen by a Professional Nurse or a Clinical Nurse Practitioner and subsequently referred.
This data element should be collected in all PHC facilities with full- or part-time doctors, as well as in hospitals that see a considerable number of PHC cases. The cause of the referral or the type of screening and/or treatment provided.
PHC case seen by doctor – not referred
A patient/client (child or adult) seen by a doctor for a Primary Health Care curative service (diagnosis and treatment), after the patient/client had been seen by a Professional Nurse or a Clinical Nurse Practitioner and subsequently referred.
This data element should be collected in all PHC facilities with full- or part-time doctors, as well as in hospitals that see a considerable number of PHC cases. The cause of the referral or the type of screening and/or treatment provided.
Doctor clinical
workdays The number of actual work days by doctors, irrespective of rank or specialty, used to perform clinical services in the facility during the reporting period (usually month). One actual work day is normally equivalent to an 8-hour shift (40 hours).
This figure should include ONLY clinical work (i.e. handling patients/clients), including normal administrative work related to patients/clients. Paid days related to e.g. training courses, meetings and other administrative issues.
12 Proportion of PHC cases
seen by doctor that is referred from nurse
PHC case seen by
doctor - referred PHC case seen by doctor - referred and not referred