Evaluating the Effectiveness of Option B+ : A National Study

Report

In 2011, Malawi pioneered an ambitious test-and-treat approach for pregnant and breastfeeding women, known as Option B+. Under this strategy, all HIV-infected pregnant and breastfeeding women are provided with lifelong antiretroviral therapy (ART) regardless of their CD4 count or clinical stage. The District Health System Strengthening and Quality Improvement for Service Delivery (DHSS) Project, in partnership with Dignitas International, supported Malawi’s Ministry of Health (MOH) in the development and roll-out of the approach. It contributed to a more than five-fold increase in the number of pregnant women enrolled on ART in the first quarter of full nationwide implementation. 

The MOH and CDC developed an evaluation of the effectiveness and impact of the national prevention of mother-to- child transmission (PMTCT) program in Malawi, which is based on the Option B+ approach. DHSS is carrying out the study, called the National Evaluation of the Malawi PMTCT Program (NEMAPP). 

The findings will be used primarily to inform the management of Malawi’s integrated ART/PMTCT program. In addition, the study provides critical insight into the impact and effectiveness of a test-and-treat approach at the population level.

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