Failure in pre-delivery adherence stands for women��s missed or delayed hospital visits to collect drugs, which has been described as one of several causes for maladherence in other studies based on self-reported adherence rates to ART among general population receiving treatment for their own health . We do not know the JNK inhibitor reasons for missed drug collection episodes in the majority of our study participants, either because they did not return to be asked, or because they did not want to state reasons. In those who shared their reasons for failure in collecting drugs, personal obstacles were mentioned most frequently, but every second of those women also stated that she failed to get drugs because of a wrongly scheduled date for the next drug collection or reluctance of drug dispensation by KDH staff. This demonstrates the crucial importance of high quality training of hospital staff . Staff were also responsible for providing correct doses of AZT and 3TC at the right time during hospitalization of mother and newborn. For only about half of the mothers and babies, at least 80% adherence was achieved. The threshold of 95% adherence was met for less than half of the mothers and only one fifth of the babies. At hospital discharge, only about 80% of mothers and babies received the right amount of take-home drugs. These intra/ postpartum adherence levels indicate suboptimal staff performance, and might partly be explained by the increased burden of work due to the introduction of combination prophylaxis. High workload can decrease motivation and dedication of staff, and might result in inadequate care. Systems of rotating staff members between departments often cause additional shortage and require continuous training of new PMTCT staff . Reducing staff rotation and ensuring a close professional supervision could mitigate the shortage of well-trained personnel, and thereby Nutlin-3 distributor considerably contribute to improved adherence rates during hospitalization. At the same time, it should be noted that in some other African countries, e.g. Kenya or Malawi, national guidelines recommend a simplified intrapartum regimen, administrating one dose of 600 mg AZT or 300 mg AZT twice daily instead of the three-hourly dosing throughout labor , a practice which could also reduce intrapartumcare-related staff burden to some extent.