Mother-to-child HIV transmission (MTCT) accounts for nearly 90% of approximately 600 000 new HIV infections that occur in children worldwide each year. Without intervention, there is a 15–45% risk of a HIV-infected mother transmitting HIV to her child during pregnancy, delivery and breastfeeding (1). Comprehensive prevention of mother-tochild transmission (PMTCT) programmes, which provide prevention messages, testing and interventions including antiretroviral (ARV) prophylaxis and replacement feeding have nearly eliminated MTCT in developed countries. However, in resource-limited settings, one of the biggest challenges is testing pregnant women and identifying HIVpositiv e women for further interventions. Provider-initiated testing and counselling (PITC), wherein HIV testing is provided as part of standard services unless the client declines (or “opts-out”), increases HIV testing uptake (2–4) is now globally recommended (5). However, implementation in resource-limited settings has been slow.