Observations were then divided into a pre-delivery and an intra/postpartum period, giving consideration to respective different implications for adherence, i.e. client-driven drug collection during pregnancy and PD-0325901 MEK inhibitor providerdriven intra/postpartum drug dispensation. All stages of data collection were supported by a trained study nurse, ensuring the routine workflow would not be disturbed. For pre-delivery data collection, study participants were interviewed during their recurrent ANC visits until delivery. The study nurse conducted interviews in Swahili or the local language, and took down answers in English. Pre-delivery questionnaires focused on aspects like drug adherence, status of HIV-disclosure, and reasons for failed drug collection in case of one or more missed drug collection episodes. General acceptance of prophylaxis among study participants was Fingolimod Src-bcr-Abl inhibitor defined as having collected AZT at least once in the pre-delivery period. Those who never collected AZT during pregnancy were considered to be declining prophylaxis. The definition of acceptance and decline was limited to the pre-delivery period because it was assumed that drug receipt during intra/postpartum hospitalization would not to the same extent reflect an active acceptance process. Intra/postpartum data collection included all study participants who returned to KDH for delivery or within 72 hours thereafter. As customary for PMTCT services, drug intake was not directly observed in most parts of the intervention. Accordingly, adherence measures assessed drug collection and dispensation rather than actual ingestion, except during intra/postpartum hopitalisation. Overall adherence was defined to consist of women��s drug collection during pregnancy , and drug dispensation by staff during/after delivery including the postpartum take-home tail . Pre-delivery adherence was measured by women��s medication possession ratio , which was generated from the number of collected AZT doses divided by the targeted number of doses between start of prophylaxis and delivery. Thus, collecting all drugs as scheduled yielded an MPR of 100%, defined as full adherence until delivery. In case of an unknown date of delivery, an estimated delivery date was used to calculate the MPR. Assessing intra/postpartum adherence was based on staff-listed dispensation of respective drugs. Adherence to sdNVP was measured in absolute intake numbers for mothers and newborns as reported by nurses, or reported by women in case of maternal self-administration.