Background PMTCT related activities in Rwanda began in 1999 with a piloting phase in Kicukiro Health Centre in Kigali City. Subsequently, PMTCT service delivery has been expanded and over 74% of total health facilities are covered in the country.

Objectives In May 2010, Rwanda commissioned the Mid-term review of PMTCT scale up plan in order to document achievements made, best practices, challenges faced and guide a development of MTCT elimination plan.

Methods Mid-term review was a cross-sectional descriptive and analytical study employing rapid participatory assessment techniques. Data collection was undertaken at national level and 15 selected health facilities located in five districts. In-depth interviews with local authorities, providers and HIV-infected mothers were conducted. Key programmatic indicators data were gathered. Data analysis was done using a range of qualitative techniques and secondary quantitative data.

Results In Rwanda, 96% of pregnant women attend antenatal care (ANC) at least once during pregnancy and receive HIV testing and counselling. In 2009, over 74% of pregnant women attended PMTCT sites and 97% of them got tested and received their HIV results. Of the expected HIV infected pregnant mothers, 78% actually received antiretroviral prophylaxis for the PMTCT. Of the expected HIV exposed infants, 64.3% actually received antiretroviral prophylaxis and the rate of MTCT dropped from 10.4% (2007) to 4.1% at 18 months of age in 2009.

Conclusions The review showed that significant progress has been made in achieving national PMTCT targets; however there is a need for interventions to increase the uptake for the PMTCT program in the country to achieve the Millennium development Goals (MDG).

Implications Rwanda is on-track to attain MDGs and the review findings lead to the development plan aiming at elimination of MTCT in Rwanda by 2012.