Background: Ghana started its PMTCT programme in 2001. Almost 10 years after its inception, an estimated 20% (2,500) of all infants born to pregnant women living with HIV in 2009 were infected with HIV through MTCT. The challenge faced by the PMTCT programme in its quest to eliminate MTCT of HIV is attributed in part to low access to ARVs for eligible
pregnant women. Objective: To identify and analyze factors influencing low access to antiretrovirals for pregnant women living with HIV to reduce mother to child transmission and help make recommendations to facilitate access to antiretrovirals. Methodology: Review and analysis of literature on PMTCT from Ghana and other low to middle income countries. Findings: Though ANC attendance is high (97%), there is low uptake of HCT (40% of ANC registrants). Out of the eligible pregnant women living with HIV in 2009, 28% had access to ARVs for PMTCT. The study identified the following as influencing factors to low uptake of HCT and ARVs: (A) Low availability (including resources) of PMTCT sites, (B) Inadequate financial and geographic accessibility to PMTCT services, (C) Low quality and acceptability of services (D) Policies and guideline challenges, (E) Individual and household characteristics. Conclusions: Improving availability of and accessibility to PMTCT services (increase service points, shifting task, and equitable distribution of services) and reviewing guideline on the use of CD4 cell count to assess ARV need have the potential to improve uptake of HCT and ARVs