The purpose of this study was to provide an understanding of the landscape of MNCH, FP and HIV/AIDS burden, service delivery gaps, and integration efforts to inform potential engagement and investments on integration grounded on the MNCH platform by the Bill & Melinda Gates Foundation and other donors. The study combined both qualitative and quantitative methodologies, including document review, collation and analysis of quantitative data, policy audits, key informant interviews and validation meetings. The quantitative data analysis informed the selection of four countries with different permutations of disease burden and service deficiency for rapid national level assessment of the status of and opportunities for MNCH, FP and HIV/AIDS integration. The four countries are the Democratic Republic of Congo (DRC), Malawi, Tanzania and Zambia. The findings show that even though there are marked differences in the way the four countries have approached MNCH, FP and HIV/AIDS integration at policy framework level, they face similar integration challenges at the system and service delivery levels. At policy level, Malawi and Tanzania have embraced the global calls for MNCH, FP and HIV/AIDS integration.