Table 1.

Summary of included studies

Study	Services integrated	Setting (participants)	Study design	Intervention description	Control description	Outcome measures
HIV
Geelhoed 2013 [44]	ART, PMTCT	Mozambique (376)	Controlled before–and–after study	MCH nurses provided all recommended health interventions applicable to both mother and child, including follow–up of HIV–exposed infants and early infant diagnosis of HIV, during the antenatal, postnatal, family planning, growth monitoring, high–risk child and vaccination consultations.	In the health care facilities of the control group, the same services were provided separately, one type of services after another, as is routine in the Mozambican public health care system.	Follow–up of HIV–exposed infants (registration, follow–up visits, serological testing); MCH attendance; Acceptability of integrated services to health care providers.
van’t Hoog 2005 [39]	PMTCT	Kenya (8231)	Historically controlled trial	HIV pre– and post–test counselling from an ANC nurse–counsellor; HIV testing at an on–site facility. The same counsellor also provided routine ANC preventive interventions like tetanus toxoid and sulfadoxine–pyrimethamine.	Opt–in HIV counselling was provided in a separate location within the hospital complex. HIV testing was conducted in an off–site laboratory.	Uptake of HIV counselling, testing and uptake of NVP.
Kasenga 2009 [47]	PMTCT	Malawi (1259)	Historically controlled trial	HIV testing and counselling services, and later on also management of sexually transmitted infections, were integrated within ANC.	Voluntary counselling and testing services were offered through a separate VCT unit at the outpatient department, through an opt–in approach.	Uptake of HIV testing
Killam 2010 [46]	ART	Zambia (31 536)	Stepped–wedge cluster non–randomised trial	Eligible women received ART in ANC until 6 weeks postpartum and then were referred to the general ART clinic.	Women found to be seropositive through ANC testing and eligible for ART were referred to the ART clinic, located on the same premises as ANC, but physically separated and separately staffed.	Proportion of treatment eligible pregnant women enrolling into HIV care within 60 d of HIV diagnosis; Proportion of women initiating ART during pregnancy.
Van der Merwe [40]	ART	South Africa (164)	Historically controlled trial	HIV testing, ART adherence counselling and treatment preparation took place within ANC. Thereafter, women were referred to hospital for initiation and follow–up of ARV treatment, which, whenever possible, was provided by the same staff members who began treatment preparation.	Pregnant women with indications for ARV treatment were referred to a hospital located approximately 1 km away, for preparation and initiation of treatment and long–term follow–up. These women were “fast–tracked” into treatment.	Pregnancy outcomes; Time–to–treatment initiation; Gestational age at ARV treatment initiation; Time from ARV treatment initiation to childbirth; Time between HIV diagnosis and receiving CD4 cell count results.
Ong’ech 2012 [38]	PMTCT	Kenya (363)	Prospective cohort study	Early infant HIV testing and prophylaxis were provided in the Maternal and Child Health clinic.	Infants were escorted to the Comprehensive Care Clinic, within the same health facility, for all HIV–related services.	Rates of attendance at each study visit (9 and 12 mo) and receipt of services for: infant HIV testing and prophylaxis at 6–8 weeks, receipt of immunizations at 14 weeks, continuation of prophylaxis at 6 mo, measles immunization at 9 mo, and HIV antibody testing at 12 mo.
Pfeiffer 2010 [45]	ART	Mozambique (unknown)	Retrospective cohort study	At integrated sites, HIV–positive women were referred to the ART clinic from ANC services within the same health unit.	At vertical sites, HIV–positive women were referred to the ART clinic from ANC services at other health units.	Loss to follow–up from referrals of HIV–positive women from PMTCT services to ART services.
Stitson 2010 [42]	ART	South Africa (14 987)	Retrospective cohort study	Site 1: ART initiated within the antenatal clinic when obstetricians with an HIV specialisation were on site. Site 2: women were referred by letter to a separate ART service located within 100 m of the maternity unit on the same premises.	Eligible women at the ANC clinic were referred to another site for HIV counselling and opt–in testing. ART was delivered at a separate primary health care facility approximately three kilometres from the antenatal service, using a referral letter.	Proportion of women who received more than 8 weeks of HAART; initiation of HAART in pregnancy.
Stinson 2013 [41]	ART	South Africa (14 617)	Retrospective cohort study.	See Stinson 2010.	See Stinson 2010.	Proportion of women who initiated ART before delivery; Time to treatment initiation.
Turan 2012 [36]	ART, PMTCT	Kenya (1123)	Cluster–RCT	At the fully integrated sites, HIV positive women were provided all ANC, PMTCT, and HIV services in the ANC clinic, including HAART for women who were eligible.	In the control (non–integrated) clinics ANC and basic PMTCT services were provided in one visit, with referral to a separate clinic in the same health facility for HIV care and treatment (including HAART if indicated, opportunistic infection prophylaxis, education, and adherence counselling).	Baseline data only (aims to report HIV–free infant survival at 6 mo; rates of maternal enrolment in HIV care and treatment; infant HIV testing uptake at 3 mo).
Vo 2012 [35] (substudy of Turan 2012 [36])	ART	Kenya (326)	Nested cross–sectional study	See Turan 2012	See Turan 2012	Satisfaction; Preferred service model; average wait times.
Winestone 2012 [37] (substudy to Turan 2012 [36]	ART, PMTCT	Kenya (36 providers)	Qualitative study	See Turan 2012	See Turan 2012	Provider perceptions of quality of care.
Munkhuu 2009 [39]	Congenital syphilis testing	Mongolia (7700)	Cluster–RCT	The one–stop service included: (i) on–site screening for syphilis using rapid syphilis tests at the first antenatal visit and at the third trimester of gestation; (ii) immediate on–site treatment for seropositive women and their sexual partners; and (iii) pre– and post–test counselling.	After being admitted to the antenatal clinic, a pregnant woman could visit any District General Hospital or the National Center of Infectious Diseases for free initial and confirmatory syphilis testing. Women testing positive would be sent to a venereologist for appropriate case management and follow–up control, including contact tracing and counselling.	Uptake of syphilis testing at the first visit and third trimester; Receipt of adequate treatment (ie, completion of 3 doses of treatment before delivery); Treatment rates for sexual partners.
Bronzan 2007 [43]	Congenital syphilis testing	South Africa (1250)	Non–randomised controlled trial	On–site antenatal syphilis screening	Off–site syphilis screening	Percentage of eligible women who received 1, 2, or 3 appropriately timed weekly doses of penicillin; Acceptability of onsite testing to nurse clinicians.
Rahman 2011 [48]	Various	Bangladesh (20 766)	Controlled before–and–after study	Set of maternal and neonatal interventions, following the continuum of care approach from pregnancy to delivery to the postnatal period, with improved links between community– and facility–based service delivery modes.	In the control areas, women receive pregnancy, delivery, and post–natal care from various government health facilities.	Perinatal mortality; Rates of facility deliveries and caesarean section.

ANC – Antenatal care; ART – Antiretroviral therapy; ARV – Antiretroviral; HAART – Highly active antiretroviral therapy; PMTCT – Prevention of mother–to–child transmission