A recent World Health Organization (WHO) report found a complex array of positive and negative impacts of global health initiatives (GHIs) on existing health systems . The report's examination of published studies and both quantitative and qualitative data collected in 15 countries demonstrated the need for programs proactively designed to have positive effects on “nontargeted” health services.

Here, we describe an effort that was designed to improve the quality and extend the impact of prevention of mother-to-child transmission of HIV/AIDS (PMTCT) care in a manner that benefited multiple areas of clinical care.