High acceptability of voluntary counselling and HIV‐testing but unacceptable loss to follow up in a prevention of mother‐to‐child HIV transmission programme in rural Malawi: scaling‐up requires a different way of acting

In a rural district hospital setting, at least 9 out of every 10 mothers attending antenatal services accepted VCT, of whom approximately one-quarter were HIV-positive and included in the PMTCT programme. The progressive loss to follow up of more than three-quarters of this cohort by the 6-month postnatal visit demands a 'different way of acting' if PMTCT is to be scaled up in our setting.