Despite massive scale-up over the past decade, pediatric antiretroviral therapy (ART) coverage rates in sub-Saharan Africa remain low. In Mozambique, only an estimated 50% of HIV-infected children were on ART at the end of 2018, compared with a 55% coverage rate in adults.1,2 Low pediatric coverage rates can, in part, be attributed to significant challenges with retention of mother–infant pairs in prevention of mother-tochild transmission (PMTCT) services with only 62% of exposed infants of women living with HIV enrolled in antenatal care having an early infant diagnosis (EID) virologic test by 2 months of age in 2018.1 For HIV-exposed infants (HEI) retained in care, the complexity of establishing the HIV status of children under 18 months of age likely also contributes to low pediatric ART coverage. Definitive diagnosis in HEIs requires a virologic EID test, which until recently was only available in centralized reference laboratories, with delayed result delivery due to transport times and the need to process samples from many health facilities. Slow delivery of EID results and subsequent delayed ART initiation lead to higher mortality rates among HIVinfected children. Point-of-care (POC) testing for EID is a recent innovation that permits health care systems to decentralize testing and bypass the inefficient networks needed for centralized testing platforms. POC EID has well-documented impact and success, virtually eliminating turnaround times and therefore permitting a same-day testing and treatment paradigm for HIV-infected infants.5–8 In Mozambique, a cluster randomized trial showed that 90% of participants accessing POC EID were linked to timely ART compared with 13% in the standard of care