The Manual is based on a public health approach to scaling-up HIV services in resource-constrained settings. Th is approach includes simple, standardized regimens and formularies; algorithmic clinical decision-making; standardized supervision and patient monitoring approaches; as well as integrated delivery of care at primary health centres within a district network. Decentralization of services to health centre and community level is facilitated with the public health approach. Th is Manual supports eff orts to deliver and scale up HIV prevention interventions including provider-initiated testing and counselling, prevention of mother-to-child transmission, prevention of HIV and TB transmission and prevention of disease progression in HIV-infected individuals. The Operations Manual deals with environmental health, logistic, managerial and infrastructure requirements for delivery of the essential HIV and primary care services. These are laid out in clinical guidelines such as country-adapted WHO Integrated Management of Adolescent and Adult Illness (IMAI), Integrated Management of Childhood Illness (IMCI) and Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines or other national clinical guidelines for provision of acute and chronic HIV care.