Table 3.

Caregivers’ barriers to nutrition and health counselling

Reported barriers	Barrier categories	Participants quotes
Time consumption	Long-distance, long queues & lengthy session & delays	“Lwak (Name of a hospital) is sometimes far, sometimes you are aware that there should be a counselling session there, but you do not have means by which to reach there. That makes it hard.” (CG_001; Mother, 30) “From here to Siaya [another hospital] is far because the clinics we have around have no counselling…. There [meaning at the hospital] they bring people together and are counselled. For a pregnant woman, it’s tiresome because sometimes you even go on foot. So those are the challenges, that’s why sometimes we don’t even go for clinics the right way” (CG_011; Mother, 40)
Inaccessibility	High transportation cost Lack of spousal support for participation in counselling	“Most of the time, I get treatment at Siaya Hospital and so I must get transport” (CG_004, Mother, 22) “…sometimes you are called today that you are needed tomorrow, and you don’t have the fare, it is difficult for you” (CG_ 025; Mother, 36) “The only challenge I would have is that sometimes my husband might not allow me to go because he knows that when I go, I might not come back” (CG_015; Mother, 25) “Only if my spouse accepts. At times he can be difficult, only if he accepts. For I would be willing but only if he accepts…” (CG_012; Mother, 33)
Inapplicability of counselling	Inaccessibility of the prescribed foods Counselling not perceived as beneficial	“I cannot find the foods that I have been trained on, so the training becomes useless. We don’t take them seriously because we don’t know what they are…” (CG_011; Mother, 40) “The teachings were good but there was no money, we were required to give the baby milk, but you don’t have the money [for purchasing the prescribed food].” (CG_024; Mother, 33)
High workload for women	Lack of time, too occupied with childcare & household activities	“At times one has a schedule of jobs to do, like us who have to take care of small children. You want to go to the farm; at times you want to go to the market and that is why you may not be able to attend nutritional counselling” (CG_014; Mother, 37) “The training can be brought there, but you have work, like now people go to the farm…” (CG_030; Mother, 30)
Sickness	Fatigue & sickness	“The other thing that can hinder someone from going is sickness,” (CG_022; Grandmother, 68)