Following the release in 2009 of the WHO PMTCT antiretroviral (ARV) rapid advice on treating pregnant women
and preventing infection in infants that recommended ARV options ‘A’ or ‘B’, Malawi recognized that neither of these
two options would best serve the national interest of treating as many women as possible to reduce mother-to-child
transmission (MTCT) of HIV. The country, therefore, decided to initiate all HIV-positive pregnant or breastfeeding
women on antiretroviral therapy (ART), irrespective of their CD4 count. This approach, a modification of the WHO
Option B, is called ‘B+’.
The documentation process involved a mixed methodology employing pre-tested tools to collect qualitative and
quantitative data on service delivery, national policy environment, plans, financial and human resources, and processes
for adoption and implementation of Option B+. Data were also collected on decentralization, task shifting, integration
with other programmes, partnerships, community engagement, challenges, limitations and lessons learnt. All the data
were appropriately analysed and are presented in this report.
The following methods were used to document this experience: (a) desk review of relevant documents; (b) key informant
interviews with relevant MOH officers, service providers, development partners, and implementing partners; (c) field visits
to selected regions, districts and health facilities to obtain relevant information and Focus Group Discussions (FGD)
with women accessing services; (d) national workshop to share the findings and incorporate the inputs of stakeholders.