When does evidence from clinical trials influence health policy? A qualitative study of officials in nine African countries of the factors behind the HIV policy decision to adopt Option B
Bibliographic Data
| ID | 12889083 |
|---|---|
| Authors | Gordon DuVal (Carleton University, corresponding author), Seema Shah (0000-0001-7726-1186, Lurie Children's Hospital) |
| Year | 2018 |
| Volume | 16 |
| Issue | 1 |
| Pages | 123-144 |
| Publication date | 2018-10-29 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Evidence & Policy (JOURNAL) |
| Journal identifiers | ISSN: 1744-2648 • E-ISSN: 1744-2656 |
| Publisher | Policy Press (PUBLISHER • GB) |
| DOI | 10.1332/174426418x15337550449872 |
| OpenAlex | W2898880723 |
| Language | EN |
| Citations received | 2 |
| References cited | 10 |
Introduction The appropriate role of evidence in health policy decision making is controversial and requires more data on how decisions are actually made. Option B+ is a strategy to prevent mother to child transmission (PMTCT) of HIV that involves starting pregnant, HIV-positive women on triple drug antiretroviral therapy (ART) and continuing for life. It was rapidly adopted by sub-Saharan African countries with limited scientific evidence for its efficacy and safety, without waiting for the results from an ongoing randomised controlled trial (RCT) comparing PMTCT strategies. Methods We interviewed 14 senior HIV policymakers in nine sub-Saharan African countries about factors influencing their adoption of Option B+. Results While scientific evidence was important to the decision to adopt Option B+, policymakers were persuaded by data that did not come from RCTs. Other factors also played an important role including: evidence for ancillary benefits, simplicity, alignment with other values and priorities, and ease of integration with existing programmes. Conclusions In adopting Option B+, gold-standard scientific evidence played a relatively minor role; other considerations were more important. Future research could help researchers determine whether these factors are influential in other contexts and to develop evidence that is more responsive to the needs of policymakers
Clinical trial · Economic growth · Economics · Family medicine · Human immunodeficiency virus (HIV · Political science · Public relations · Qualitative research · Randomized controlled trial · Scientific evidence · Sociology · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Poverty, Education, and Child Welfare · Surgery
Adherence to antiretroviral therapy during and after pregnancy in low-income, middle-income, and high-income countries
Maternal mortality for 181 countries, 1980–2008
The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings
Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission
New directions in evidence-based policy research
Prevention of HIV-1 Infection with Early Antiretroviral Therapy
Choose Your Method
Act local, think global
Reconsidering evidence-based policy
Beyond the usual suspects
| Citations per year | 0.4 |
|---|---|
| Citation span | 2021 - 2021 (1) |
| Highly cited | No |