In the early response to the HIV epidemic in Mozambique, paediatric antiretroviral treatment (ART) was principally available in day clinics, located in referral hospitals, with strong linkages between the inpatient wards and outpatient ART clinics. In 2013, the Ministry of Health (MoH) launched an acceleration plan that prioritized decentralization and scale‐up of ART services throughout the country [1]. The results of this effort have been remarkable with the comparison of key indicators from 2013 to 2021 demonstrating the percentage of health facilities offering ART increasing from 39% to 96%, the number of children on ART increasing from 41,400 to 99,169 and the estimated paediatric ART coverage increasing from 41% to 79% [2, 3]. | | To achieve these results, outpatient HIV care at primary health centres became the principal focus of programmatic attention, with an unintended negative impact on the quality of inpatient HIV care for children at referral hospitals. Programmatic data and local operational research demonstrated significant gaps at hospitals along the continuum of paediatric HIV care, including provider‐initiated testing and counselling (PITC), early infant diagnosis (EID) for HIV‐exposed infants, inpatient ART initiation and linkage to care post‐discharge [3, 4, 5, 6].