"In some periods, there is a shortage of SD-NVP for PMTCT. We could not do anything in that situation. In practice, the NVP syrup for children is very inconvenient to use. On one day, we have no more than two children to treat; we have to open one bottle for them and the rest of the syrup is unused. The syrup quickly runs out, and then we don't have medication for another child." Manager, ANC provincial hospital "We also counsel them to use condoms. If someone asks me what they should do to avoid unwanted pregnancy then I tell them. But I do not have condoms to give them for free for family planning." Counsellor, ANC district level Another issue is that there are no national guidelines on counselling and testing. Observation showed that facilities at provincial and national levels had counselling and PMTCT guidelines and protocols developed by the projects that support those facilities, but most facilities at district or lower level do not have guidelines or even access to them.