Lessons Learned From Early Implementation of Option B+
| Autor: | Mary Pat, Kieffer, Meghan, Mattingly, Anja, Giphart, Roland, van de Ven, Caspian, Chouraya, Moses, Walakira, Alexandre, Boon, Silvia, Mikusova, R J, Simonds, Esther, Tumbare |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Program evaluation Pediatrics medicine.medical_specialty Pediatric AIDS Anti-HIV Agents Service delivery framework antiretroviral therapy Staffing Option B+ Developing country HIV Infections Context (language use) World Health Organization Nursing Pregnancy medicine Humans Pharmacology (medical) Pregnancy Complications Infectious Child Acquired Immunodeficiency Syndrome implementation science business.industry Infant Newborn Infant Infectious Disease Transmission Vertical Breast Feeding prevention of mother-to-child transmission of HIV Infectious Diseases Child Preschool Africa Workforce Female Supplement Article business Breast feeding Foundations Program Evaluation |
| Zdroj: | Journal of Acquired Immune Deficiency Syndromes (1999) |
| ISSN: | 1525-4135 |
| Popis: | Background: “Option B+” is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. Methods: This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Results: Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Discussion: Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation. |
| Databáze: | OpenAIRE |
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