A decision was made by the National Department of Health at the end of 2000 to implement two PMTCT pilot sites in each province of South Africa. Health Systems Trust was subsequently commissioned to evaluate progress with implementation in the pilot sites, and released a report in February 2002 covering the period January to December 2001.This second and final evaluation report on the PMTCT pilot sites builds on the previous one, and describes progress made between January and December 2002 in the same 18 pilot sites. This study forms part of the national research framework for the PMTCT programme, and reference is made in sections of the report to work conducted in other components of the overall PMTCT research. The focus of this report is on the performance of the original pilot sites, but attempts are made to describe the process underway in each of the provinces to expand this programme beyond the pilot sites. This evaluation also assesses whether lessons learnt and problems identified from the first evaluation have been addressed.