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There is little doubt that HIV treatment, care and support, and prevention of mother-to-child transmission (PMTCT) programs are most effective when they are based on the best available research evidence.1 This is the fundamental premise of evidence-based medicine. Equally well-known is the dilemma of transforming evidence into practice, which is the subject of knowledge translation and implementation science. Even when the tional and national program guidelines, they run up against the reality of competing priorities within public health and community programs, resource constraints, and institutional and human inertia.

From problem-solving to research utilization: How operations research and program evaluation can make programs better