Table 4.

Policy and program implications of the findings

Areas of interest	Constraints and barriers	Favorable factors	Opportunities for intervention
Quality of services	- Long waiting hours - Lack of cleanliness - Lack of BCC materials -Inadequate training -Stock outs	- Providers are aware of the need of providing quality service -Trust in health care providers -Availability of female providers	- Engaging volunteers to provide health education at facility level -Utilize waiting time to provide health education and information (such as short films) -Develop a mechanism for monitoring health system readiness -Develop a mechanism for client feedback - Invest in providing regular pre-service training and supportive supervision to frontline health workers on nutrition -Design mechanisms (awards, incentives) to ensure that health workers provide good quality nutrition services -Create opportunity for well child visits
Awareness in the community	- Mothers were unaware of the services at the facility -Lack of continuity of care -Lack of access to clients -Inflexible design of program -Lack of resources	-Demand for the Nutrition services -Trust in the services provided - Providers are interested in reaching out to the clients	- Communication strategies need to be designed with the characteristics of urban population in mind - Mechanisms need to be designed to allow mothers to avail continuity of care - Create demand for well child visits
Policy and program	-Contracting process of NGOs do not have sufficient safeguards to ensure quality nutrition service delivery - Low program cost is prized over quality of service	-There is policy emphasis on nutrition - Nutrition has been integrated in the existing MNCH programs -Some nutrition indicators are incorporated in the monitoring reports	-Model for quality nutrition service delivery in urban areas should be developed -Contracting process for NGOs should be based on quality of nutrition service provision -Programs should be provided so flexibility to respond to the needs of the clients -Programs should be adequately budgeted to allow good quality nutrition services