Introduction <p>Despite Ghana’s launch of the National Viral Hepatitis Control Programme in 2011, a comprehensive strategy for controlling hepatitis B Virus (HBV) infection among pregnant women, as envisioned by the World Health Organization’s triple elimination goals for the vertical transmission of HIV infection, syphilis and HBV infection, remains undefined. This study aimed to explore pathways for integrating HBV infection testing and treatment into routine prevention of mother-to-child transmission (PMTCT) services in Ghana’s Upper West Region. In doing so, it was guided by the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementing Change (ERIC) frameworks.</p> Methods <p>This study employed a Rapid Qualitative Analysis approach, involving 15 purposively selected participants across three healthcare levels: senior managers/policymakers (<i>n</i> = 3), junior managers (<i>n</i> = 5), and service providers (<i>n</i> = 7). Data were collected through semi-structured interviews, transcribed verbatim, summarised in a data matrix, and analysed using directed content and inductive analysis. Key implementation barriers and facilitators were identified through CFIR constructs, with corresponding strategies developed using the CFIR-ERIC implementation strategy matching tool.</p> Results <p>Eight barriers and four facilitators were identified across the CFIR domains. Key barriers included trialability, complexity, cost, external policy gaps, inadequate leadership engagement, resource limitations, and deficiencies in planning. Facilitators encompassed evidence strength and quality, cosmopolitanism, compatibility, and positive knowledge and beliefs about the intervention. Five clusters of implementation strategies emerged: financial strategies, evaluative and iterative strategies, infrastructure redesign, stakeholder relationship building, and context-specific adaptation and tailoring of interventions.</p> Conclusions <p>Integrating HBV infection testing and treatment into routine PMTCT services is both viable and essential for improving maternal and child health outcomes in Ghana’s Upper West Region. Despite significant challenges, the identified facilitators and proposed interventions provide a comprehensive roadmap for addressing implementation barriers. Achieving successful integration requires coordinated efforts among stakeholders, including policymakers, healthcare professionals, and community leaders, to ensure the sustainability and effectiveness of HBV infection management within existing PMTCT frameworks.</p>