In the past, programs for prevention of mother-to-child transmission (PMTCT) of HIV functioned in independent silos. In a move to improve the quality of PMTCT services and increase access to services, programs are moving towards an integrated approach. Increasingly, the comprehensive package of PMTCT services is being offered as part of such routine health services as primary health care, maternal and child health care, and family planning. Included in this section of the toolkit are resources that provide guidance on the integration of health services to help policy makers and program managers with integrating programs and services that can efficiently and effectively address PMTCT.

The vast majority of women who need services for the prevention of mother-to-child transmission (PMTCT) of HIV lack access to them. Although many high-quality PMTCT programs exist, they are concentrated in major urban areas. Donor and government support is insufficient to support wide scale access to basic PMTCT programs. In this section of the toolkit you will find resources that address the financial challenges surrounding PMTCT programs and services as well as some approaches for addressing financial constraints.

In most high-income countries, wide implementation of an evidence-based package of prevention of mother to child transmission (PMTCT) interventions built around the use of antiretroviral drugs, avoidance of breastfeeding and elective cesarean section has virtually eliminated new HIV infections among children. However, in resource-limited settings, little progress has been made in scaling up PMTCT services and in designing comprehensive programs that address each of the key elements outlined in the PMTCT strategy of the World Health Organization (WHO). Only 10% of women in need of PMTCT services actually access them. In order to support rapid scale-up of comprehensive PMTCT programs, WHO recommends a set of country-level strategies. Resources on scaling up services, including the WHO guidance for scaling up PMTCT activities, can be found in this section of the toolkit

The shortage of health care workers is a significant barrier to scale-up of services for the prevention of mother-to-child transmission (PMTCT) of HIV, particularly in resource-limited and high-burden settings. In response to this challenge, task-shifting strategies have been implemented in a number of settings. Task shifting involves the redistribution of tasks among cadres of health care workers. Specific tasks are moved, where appropriate, from highly qualified health workers to health workers with less training and fewer formal qualifications. In this section of the toolkit you will find the WHO global recommendations and guidelines on task shifting among health workers.