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Options B and B+: key considerations for countries to implement an equity-focused approach

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New York, UNICEF, 2012

This document is meant primarily to help countries that desire to be ahead of the curve and begin the process of preparing to adopt Option B or B+ now. The document therefore contains considerations on key policy, programmatic and partnership issues that relate to implementation of Option B or B+. Planning well to address these key issues can hopefully help countries “hit the ground running” and avoid unnecessary bottlenecks in rolling-out Option B or B+.
The document does not provide new formal guidance, but rather discusses technical considerations that are relatively broad in scope, so that different country contexts can adapt the advice to their more specific needs. Additionally, as was suggested in the WHO programmatic update, it is hoped
that as countries consider what is a best fit for their context, valuable lessons will be learned that can be shared more broadly and feed into the global revisions of HIV recommendations by WHO in 2013. While this document may contain helpful advice for any country considering adopting Option B or B+, it especially focuses on the advantages of Option B+ in high and intermediate prevalence countries, urging such countries to consider adopting an implementation model of nurse-initiated ART in MNCH settings. This document draws to some extent on the early experience of Malawi, the first low-income country to successfully begin implementation of Option B+ on a nationwide scale.