The objective of our intervention was to examine the benefits of incorporating traditional birth attendants (TBA) in HIV
Prevention of Mother to Child Transmission (PMTCT) service delivery. We developed a training curriculum for TBAs related to
PMTCT and current TBA roles in Malawi. Fourteen TBAs and seven TBA assistants serving 4 urban health centre catchment
areas were assessed, trained and supervised. Focus group discussions with the TBAs were conducted after implementation of the
program. From March 2008 to August 2009, a total of 4017 pregnant women visited TBAs, out of which 2133 (53.1%) were
directly referred to health facilities and 1,884 (46.9%) women delivered at TBAs and subsequently referred. 168 HIV positive
women were identified by TBAs. Of these, 86/168 (51.2%) women received nevirapine and 46/168 (27.4%) HIV exposed infants
received nevirapine. The challenges in providing PMTCT services included lack of transportation for referrals and absence of a
reporting system to confirm the woman’s arrival at the health center. Non-disclosure of HIV status by patients to the TBAs
resulted in inability to assist nevirapine uptake. TBAs, when trained and well-supervised, can supplement efforts to provide
PMTCT services in communities