Without strong integration of family planning into PMTCT services in Rwanda, clients remain with a high unmet need for effective family planning.

In 2008, about 33.4 million people were estimated to be living with HIV worldwide, including about 15.7 million women and 2.1 million children under the age of 15. 1 The majority of new infections in children occur as a result of vertical transmission, either in the course of pregnancy, during labour, or through breastfeeding. The risk of mother to child transmission can be reduced from 15-45 percent to less than 2 percent with highly active antiretroviral therapy which, along with the practice of delivering babies of HIV-positive mothers by elective Caesarean section and bottle feeding, has effectively eliminated vertical transmission in highincome countries. 2-4