Table 3. Summary of faciltators and barriers to SMC uptake amongst caregiver respondents, collected during a qualitative study in Ghana in January 2013.

Facilitators of SMC uptake	Barriers to SMC uptake
• Trust in and respect for authorities who were seen to sanction and implement the SMC	• SMC programme was incompatible with some caregivers perceived needs, who believed there was no need to medicate children who were not sick and their time was better spent at work
• Proximity to and communication of fixed point delivery (community gatherings)	• Large distances to travel, restricted timings of, and poor communication of fixed point delivery (community gatherings)
• Flexible door-to-door (household) delivery	• Delivery of medication only to primary caregiver during door-to-door visits
• Beliefs that any perceived side-effects of SMC were attributable to the SMC medication treating undiagnosed malaria in the child	• Beliefs that any perceived side-effects of SMC were attributable to the SMC medication harming the child
• CHW supervision and administration of medication directly to the child at home.	• Need to consume all SMC medication over 3 consecutive days within a month.
• Reference to IPTp to explain the difference between malaria treatment medication and malaria prevention medication	• Caregivers found the concept of preventive medication difficult to understand despite experience of IPTp and the SMC programme
• Observation of other caregivers’ participation and their perceived positive health responses	• Belief the intervention was for research only and not routine care
• Reassurance from CHWs and senior family members on perceived side-effects (the basis for a supportive community-based network)