Recognizing the need to improve the care and follow up of mothers and infants in the postpartum period, the Lesotho Ministry of Health and Social Welfare (MOHSW), with technical support from the Frontiers in Reproductive Health Program (FRONTIERS) of Population Council and funding from PEPFAR/RHAP/USAID, carried out an operations research project to strengthen the existing postpartum care services. In Lesotho, only 28 percent of new mothers receive a checkup after delivery (LDHS 2004). The prevention of future unintended pregnancies as a strategy and fundamental component of PMTCT programs has not received much attention to date, and is the focus of this project. This study has a specific focus on strengthening linkages with existing PMTCT follow up services and family planning services during the postpartum period by changing the number, timing and content of postpartum consultations that a woman and her newborn should receive. The objectives of the study were: 1) to develop and introduce a strengthened postpartum care package with three consultations within 48 hours, one week and six weeks; and 2) to document the feasibility and quality of care of the strengthened postpartum care package, and its acceptability to providers and postpartum women. Researchers used a pre- and post-test design to assess the effectiveness of the new postpartum package of care in the district hospital and four public health centers in Butha Buthe District in the north of Lesotho. To assess quality of care within the facilities, data were collected through interviews with health care providers, structured observations of client-provider interactions and a facility checklist for assessing availability of equipment and supplies to provide PNC. Women were also interviewed on the postnatal ward before and after the intervention. Focus group discussions with both providers and clients took place following the intervention to assess the acceptability of the new services. Data collection took place in October 2006 and July 2007. A postpartum package of care was developed by FRONTIERS in conjunction with the MOHSW and stakeholders from national institutions. Results from the baseline data contributed to developing training materials, job aids and an information leaflet. A postpartum register was also introduced and piloted in the intervention sites. Essential items of equipment were distributed to the health facilities. The training package was pre-tested in another district (Leribe District) with similar characteristics to Butha Buthe district. Three supervision visits were made to the five intervention facilities between March and May 2006. Twenty-four providers were trained over three days from 16 health facilities in the districts. All 24 providers made an action plan to introduce the PNC services into their places of work and update their colleagues.