This report highlights findings from an implementation evaluation of Option B+, a Universal test and treat Strategy for HIV infected pregnant and lactating women to prevent mother-to-child transmission of HIV (PMTCT). This evaluation sought to understand Option B+ implementation in South Africa, three years after the policy was changed. We conducted a mixed-methods, multi-level programme evaluation to understand the views and experiences from policy-makers’, health care providers’ and users’ perspectives and to identify opportunities for programme strengthening.
The report is based on interviews (quantitative and qualitative) conducted at national, provincial, district, health facility and individual levels in six purposively selected districts [(OR Tambo in Eastern Cape (EC); Ekurhuleni in Gauteng (GP); eThekwini in KwaZulu-Natal (KZN); Greater Sekhukhune in Limpopo (LP); Ehlanzeni in Mpumalanga (MP) and Bojanala in North West (NW)]. These districts were selected from 25 districts that had the highest number of polymerase chain reaction (PCR) positive infants in 2014 and 2015. We also randomly reviewed records and conducted facility observations.
With this report, we highlight implementation strengths, bottlenecks and lessons learnt and offer insights on how the PMTCT Option B+ programme could be strengthened.