ArticleHealth policy and planning2017
Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.
Article in Health policy and planning, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Approaches to transitioning women into and out of prevention of mother-to-child transmission of HIV services for continued ART: a systematic review.Journal of the International AIDS Society · 2021Pooled it
- The effects of revised peer-counselor support on the PMTCT cascade of care: results from a cluster-randomized trial in Kenya (the EMMA study).BMC infectious diseases · 2023Trial
- Stepped-Wedge Cluster Randomized Controlled Trial to Promote Option B+ Retention in Central Mozambique.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Trial
- Viral suppression among patients in HIV/AIDS care at healthcare facilities in Ethiopia: Same-day antiretroviral initiation.PloS one · 2025Article
- Womandla Health: development and rationale of a behavioral intervention to support HIV treatment adherence among postpartum women in South Africa.BMC women's health · 2023Article
- An assessment on the implementation of same day antiretroviral therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa.Journal of public health in Africa · 2023Article
- Article
- 'When I receive ARVs through my group, my heart settles': Participants' perceptions and experiences of Friends for Life Circles for Option B+ in Kampala and Mityana Districts, Uganda.PLOS global public health · 2023Article
- 'I need time to start antiretroviral therapy': understanding reasons for delayed ART initiation among people diagnosed with HIV in Lusaka, Zambia'.Annals of medicine · 2022Article
- Prevalence and factors associated with delayed antiretroviral therapy initiation among adults with HIV in Alebtong district, Northern Uganda: A facility-based study.PLOS global public health · 2022Article
- Loss to follow-up in "test and treat era" and its predictors among HIV-positive adults receiving ART in Northwest Ethiopia: Institution-based cohort study.Frontiers in public health · 2022Article
- Loss to follow up after pregnancy among mothers enrolled on the option B+ program in Uganda.Public health in practice (Oxford, England) · 2021Article
- A Social-Ecological Framework to Understand Barriers to HIV Clinic Attendance in Nakivale Refugee Settlement in Uganda: a Qualitative Study.AIDS and behavior · 2021Article
- Understanding the influence of health systems on women's experiences of Option B+: A meta-ethnography of qualitative research from sub-Saharan Africa.Global public health · 2021Article
- "This is My Life We are Talking About": Adaptive Strategies for HIV Care Retention and Treatment Adherence Among Postpartum Women Living with HIV in Cape Town, South Africa.Maternal and child health journal · 2020Article
- Immediate Antiretroviral Therapy: The Need for a Health Equity Approach.International journal of environmental research and public health · 2020Article
- Barriers to maternal retention in HIV care in Ghana: key differences during pregnancy and the postpartum period.BMC pregnancy and childbirth · 2020Article
- Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China.BMC infectious diseases · 2020Observational
- Costs and Cost Drivers of Providing Option B+ Services to Mother-Baby Pairs for PMTCT of HIV in Health Centre IV Facilities in Jinja District, Uganda.BioMed research international · 2020Article
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Authors and funding
11 authors.
Funding
Abstract
Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.
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