title: Building a national direction for research in the prevention of mother to child transmission of HIV: results from a national prioritization initiative in Malawi.
abstract: BACKGROUND
  In 2011, Malawi initiated an ambitious program for the prevention of maternal to child transmission (PMTCT) of HIV, called 'Option B+,' which employs a universal test and life-long treatment strategy for all pregnant women. Priority setting should take place in defining a national research agenda for evaluating Option B + rollout in Malawi.
  
  
  METHODS
  In April 2011, a three-day workshop took place for all major stakeholders in PMTCT aiming to provide an update on current PMTCT operational research in Malawi, find consensus on key questions not yet being addressed, identify opportunities for collaboration, and develop multi-partner research proposals.
  
  
  RESULTS
  Overall, 24 participants attended the workshop including representatives from the Ministry of Health, the National AIDS Commission and 12 multilateral, non-governmental organizations and academic partners.Three interrelated clusters emerged as priorities for research: i) pregnancy intentions and family planning needs; ii) evaluation of models of care; and iii) determinants of uptake, adherence, and retention of women for Option B+. In addition, two cross-cutting themes arose: partner involvement in PMTCT services and cost-effectiveness as a guide to priority setting. Within each cluster a coordinator was designated and a proposed plan for research and potential collaborators were discussed. The results of the workshop were presented to the national technical working groups and the National AIDS Commission. Several large-scale, collaborative proposals have been developed and funded to address the research areas defined.
  
  
  CONCLUSIONS
  Option B + represents a significant change in PMTCT policy in Malawi and the process for evaluation of the Malawi PMTCT strategy is outlined. This workshop contributed to defining and coordinating the national agenda for research priorities.
authors.forename: Megan
authors.initials: M
authors.lastname: Landes
authors.affiliation: Dignitas International, PO Box 1071 Zomba, Malawi. m.vanlettow@dignitasinternational.org.
authors.forename: Monique
authors.initials: M
authors.lastname: van Lettow
authors.forename: Fabian
authors.initials: F
authors.lastname: Cataldo
authors.forename: Adrienne K
authors.initials: AK
authors.lastname: Chan
authors.forename: Beth
authors.initials: B
authors.lastname: Tippett Barr
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
authors.forename: Richard
authors.initials: R
authors.lastname: Bedell
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D002648:Child; D003226:Congresses as Topic; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care; D005193:Family Planning Services; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000635:transmission; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D009035:Mothers; D010349:Patient Compliance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D037841:Pregnant People; D015397:Program Evaluation; D012106:Research; D012747:Sexual Partners
chemical_list: D019380:Anti-HIV Agents