Table 4 Illustrative quotes for emerging themes expressed by in-depth interview respondents, by study arm

Relative advantage

a. “The MWH is near the clinic. You can walk from the MWH to the clinic and deliver; it is a shorter distance. The village is far and they built that MWH to help us find it easy to utilize the service without spending much on transport and for those with no means, they also assist them while at the MWH.” – Woman, Kalomo District

b. “[Women] use them [MWHs], because they want to be closer to the facility, rather than going when they are due. They want to avoid delivering on the way and in the village. Even after delivery they will stay there [at the MWH] for observations, maybe for three days or more.” – Woman, Mansa District

Compatibility

c. “The place is clean, well furnished with mattresses, mosquitoes and other requisites including beds and beddings. These are helpful because not every woman is able to afford them. They also have water, electricity, and toilets.” – Woman, Mansa District

d. “We cook for ourselves so that we stay well at the MWH. We cook at the MWH with no problems.” – Woman, Choma District

e. “Others don’t go because they fear that they will be sleeping on the floor and experience a lot of discomfort including body pains. There are no beds, sometimes water is a problem or there is no electricity.” – Woman, Choma District

Complexity

f.”What makes it hard sometimes is the fact that women are unprepared in terms of requirements for when the baby arrives. Sometimes they rely on old clothes or the nappies are worn out or stained and they feel embarrassed to take them to the MWH.” – Woman, Choma District

g. “Most women complain about food, because we go very early and spend more on food and other things, transport also. It happens that you go rushing [to the MWH] without any money. But, otherwise, it is okay.” – Woman, Chembe District

h. “The children are home alone and rely on you to provide for them, so it’s difficult. Personally, I would not love to go there [the MWH], because I have no one to care for my children.” – Woman, Chembe District

Observability

i. “The nurses do teach [and] raise awareness about the MWH. The community volunteers as well do a lot of encouraging [even] more than the nurses and also our spouses and village headmen.” – Woman, Pemba District

j. “During community meetings or gatherings organized by village headmen, they make announcements about the availability of these MWHs. They also encourage women to utilize these MWHs during the same meetings. – Woman, Kalomo District

k. “The health facility staffs do give out the information about the MWH during health education when women go for ANC. The health facility staff tell us that when your pregnancy is eight months, you should come and stay close to the clinic.” – Woman, Lundazi District