MSH Supporting Roll Out of Option B+ in Uganda

{Photo credit: Glenn Ruga/MSH, Uganda.}Photo credit: Glenn Ruga/MSH, Uganda.

After much anticipation, the USAID-funded Strengthening TB and AIDS Response – Eastern Region (STAR-E) project, led by Management Sciences for Health (MSH), has begun supporting the roll out of the Option B+ treatment program in Uganda.

Option B+ is a novel approach to prevent mother-to-child transmission (PMTCT) of HIV that provides antiretroviral treatment (ART) for life to all HIV-positive pregnant women, regardless of their CD4 count. Most approaches to PMTCT in developing countries remove the mother from antiretroviral therapy once the baby is born, thereby virtually ignoring the health and survival of the postpartum woman. Option B+ exemplifies integrated maternal health and HIV prevention by addressing the wellbeing of the pregnant woman for her own sake, not simply as a vessel for an HIV-negative baby.

Working with the Ugandan Government, STAR-E is now rolling out this program to 12 districts in Eastern Uganda through 154 project-supported health units and their communities. The first phase of this roll-out, which included the massive task of training over 1,000 facility-based health workers, was completed on May 11, 2013. These health workers were trained over the course of four weeks and are receiving ongoing guidance through mentorships to each facility. 

The project has engaged the leadership and opinion leaders in all 12 districts and their sub-districts and worked with the Ugandan Ministry of Health to create radio programs and printed materials to educate the communities. The radio programs were broadcast on four radio stations, meetings were held with community leaders, and printed materials were distributed to communities.    

Additionally, STAR-E has trained 36 health management information system (HMIS) focal persons and records assistants from high volume sites (hospitals and health center IVs) on Option B+ related data management. The project is working with the ministry to pilot the Option B+ data collection tools in a few selected STAR-E supported facilities before adopting the last changes in the HMIS monthly reporting form for the whole country. 

The final piece of this first phase was the procurement of Option B+ medicines that have been distributed to all 154 sites. This first disbursement will last for two months. STAR-E is working with the facilities to quantify their needs for their next round of medicines.  

There is much excitement in the Ugandan health community regarding Option B+. STAR-E looks forward to continuing its activities in this area through the end of the project in March 2015 and ensuring the sustainability of this form of care for the women of Eastern Uganda.

Denis Kintu is a PMTCT advisor for the Strengthening TB and AIDS Response – Eastern Region (STAR-E) project in Uganda.

MSH worked with the Ministry of Health in Malawi to develop Option B+, which is now fully adopted by the World Health Organization (WHO).