Table 2.

Changes attributed to CHWs’ activities

Change described	Examples given of CHW-enforced behaviours associated with the change
Changes during pregnancy and labour
Increased ANC attendance	Pregnant women and husbands/partners informing CHWs of a pregnancy; more women attending ANC during the first trimester
Increase in birth- preparedness activities	Husbands/partners save money, provide women with money for emergencies, transport, and babies’ needs
	Women buy mama kit items
	Women ask CHWs to educate them in presence of husbands
Increased knowledge on pregnancy health issues	Women attend to their health needs during pregnancy
	Women try to eat healthy/balanced diets
More likely to seek care	Women recognise danger signs
	Women initiate contact with CHW or health facility in case of swelling, general weakness, or if a decrease in baby's movements felt
	More deliveries at health facilities
Improved health worker/client relationship	Women experience a caring attitude from health workers, as the latter are less constrained when women have mama kits and ANC cards
Health workers recognise referrals	Women with CHW referral slips are seen faster at hospital or health unit
Changes during postnatal period
Increased awareness of needs of newly delivered mothers and babies	Women put only salty water on the baby's umbilical cord rather than animal dung and herbs
	Bathing is delayed instead of immediately practised
	Men also acknowledge the importance of these practices
	CHWs are sought outside of routine visits regarding danger signs
More use of health facilities	More women taking their newborn babies for postnatal care, including immunisation
	Seeking medical care from qualified persons
	Newly delivered mothers reaching out to CHWs when self or infant is unwell
Improved breastfeeding	Immediate breastfeeding at birth and continuous breastfeeding
	Delayed introduction of other feeds
	More women giving colostrum