Table 2

Key barriers and facilitators to facility-based delivery reported by qualitative participants during the endline observation of the MWH impact study, by study arm

Key themesInterventionControl
Barriers influencing facility delivery

  1. Distance and transportation: health facility is far, have to prepare transport and money, buy fuel in advance or walk a long way; bad roads

  2. Costs associated with delivery: need to prepare money for transportation (costs more if distance is farther) and buy required delivery supplies

    1. Costs associated with MWH stay: need to bring food to cook during stay

    2. Stigma related to costs: worried, scared or embarrassed about not having the delivery supplies required and/or baby clothes to bring to the health facility

  1. Distance and transportation: health facility is far and transportation is challenging, have to plan to walk early and wait at the facility or MWH if there is one or need to prepare transport and money

  2. Costs associated with delivery: need to prepare money for transportation and buy required delivery supplies

    1. Stigma related to costs: scared or embarrassed about not having delivery requirements and/or baby clothes to bring to the health facility

Facilitators influencing facility delivery

  1. Costs associated with delivery: no cost to deliver at a facility; no cost to stay at MWH

  2. Penalties for home delivery: penalty fee for home delivery—pay the chief and health facility; penalty made women fear home delivery though some believed it is a hoax

  3. Safe delivery: concerned about complications at home and afraid of dying; safer to deliver at facility, where staff can help with complications

  4. MWH availability: good to move to MWH before delivery to avoid transportation difficulties because health facility is far

    1. Advised to stay by health facility staff at 8 months if woman lived far away

    2. MWH is free and has amenities such as beds, blankets and cooking supplies

  1. Costs associated with delivery: no cost to deliver at a facility

  2. Penalties for home delivery: penalty fees for home delivery—pay the chief and health facility; penalty made women fear home delivery

  3. Safe delivery: concerned about delivery complications at home, and afraid of dying from complications; safer to deliver at facility, where staff can help with complications

  4. MWH availability: women chose to go to health facilities with MWH no matter how far; good for those who live far away from the facility—can rest before delivery; no MWH but want one in their area; MWH availability does not matter, women will go where they can deliver safely

  • MHW, maternity waiting homes.