Background:“Option B+” is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+.Methods:This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies.Results:Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality.Discussion:Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation.
This article provides an overview of the NACP, as well as a summary of the competencies necessary for fully professional practice across the various settings in which child and youth care professionals work. Competencies for Professional Child and Youth Work Professionals, (Revised 2010), with a complete description of the project can be found at www.acycp.org or www.cyccb.org/competencies. This document is the result of many years of work by North American Child and Youth Care Professionals. Initial development was undertaken by the North American Certification Project (NACP) and, sponsored by the Association for Child and Youth Care Practice (ACYCP). The NACP arose from a broad opinion that North American certification for child and youth care practitioners was urgently needed. GuIDInG FOunDATIOnS OF THE PrOJECT The project was guided by the following description of the field and guiding principles. Description of the Child & Youth Care Field Professional child and youth care practice focuses on infants, children, and adolescents, including those with special needs, within the context of the family, the community, and the life span. The developmental ecological perspective emphasizes the interaction between persons and their physical and social environments, including cultural and political settings. Professional practitioners promote the optimal development of children, youth, and their families in a variety of settings, such as early care and education, commu
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