Table 3 Qualitative themes for each diffusion of innovation theory constructas expressed by in-depth interview respondents, by study arm

Relative advantage

• Attended by health staff: staff checked on, taught and encouraged women; staff can help with complications immediately; health facility linked with MWH

• Near health facility: can go quickly to the facility from MWH to deliver once labor starts; helpful for those who live far

• Attended by health staff: staff can help with complications immediately; staff checked on women

• Near health facility: can go quickly to the facility from MWH to deliver once labor starts; avoid delivering on the way; helpful for those who live far

Compatibility

• MWH quality: built well; comfortable; had needed amenities and facilities

• Safety: felt safe, like home; no theft; protected from diseases such as malaria and those linked to poor sanitation

• MWH managed well: kept clean; taken care of by health facility staff and MWH worker

• MWH too small: MWH overcrowded, some women end up using the old MWH; not enough beds, some sleep on the extra mattresses

• MWH quality: women “stay well”; a place to sleep and cook; easier to stay if prepared

• Poor quality of MWH: not comfortable; facilities in bad condition and need repair; no beds or mattresses; dirty; no cooking area; no water or electricity

• Safety: felt safe; near trained health staff; protected from diseases (not specified)

• Lack of safety: shared space with other people waiting for sick relatives; need wall or fence; no door

• MWH managed well: health staff managed the MWH; kept clean

• MWH too small: overcrowded; pregnant women mixed with other people waiting for sick relatives; no place to put belongings

Complexity

• Lack of preparation: no money or ran out of money to use during stay for food and other items; did not buy baby clothes or required delivery supplies

• Not enough food: ran out of food and cannot go back home to get more; no money to buy food during stay

• Distance & transportation: far distance from home to MWH; lack transport

• Lack of preparation: no money or ran out of money to use during stay for food and supplies; did not buy required delivery supplies or baby clothes

• Not enough food: not enough food to take to MWH

• Children and husband at home: family relies on woman at home; no one to stay with children at home

Observability

• Sensitization about MWH: received messaging about the MWHs from health facility staff, volunteers, and traditional leaders; also heard benefits from other community members and from radio messaging

• Sensitization about MWH: received messaging about the MWHs from health facility staff and volunteers