Table 3.

Stakeholder experience and implementation factors in studies detailing interventions promoting awareness of women’s rights for maternity care services with reported specified health outcomes (N = 4)

Supportive implementation factors	Challenging implementation factors	Studies
		Pandey et al. 2007	Björkman & Svensson 2007	Ganju et al. 2014	Sinha 2008
Stakeholder Experience And Implementation Factors
Women
Increased awareness and self-esteem					X
Supportive friends and family members, peer-based learning					X
Support groups that provide a space for social bonding, discussion, breaking down isolation, building social ties, changing social norms					X
	Low literacy among women, migration of pregnant women			X
Community
Support from community leaders					X
Volunteers with prior experience working in intervention communities and trusted by community				X	X
Volunteers with strong relationships with health services enabling better linkages between communities and health services					X
Community awareness and support; participatory analysis and community dialogue combined with critical reflection and social analysis to identify hidden issues and underlying, root causes				X	X
Peer pressure to prevent harmful practices by traditional healers, violence against women, early marriage, dowry					X
Strengthening existing community governance structures related to health and if they are not functional, either dissolving them or creating parallel mechanisms to ensure community voice			X	X	X
Increased frequency of health committee meetings, although community members were not aware of this		X
Community awareness of health committee roles and responsibilities			X
Community action to improve inputs for local health care services fostering a sense of mutual commitments to improving health				X	X
Explicit equity considerations: Separate meetings within communities to ensure representation of interests by marginalized groups; Tailored capacity-building and accompaniment processes; Identification of champions from among the most poor and marginalized.	Social inequality, caste hierarchies, gender discrimination	X	X
	Feeling by community members that sharing information on entitlements was futile, incomprehensible or fearful	X
	Vested interests from local elected representatives that are unresponsive to community development needs.	X
Health Providers
Health provider knowledge about patients’ rights			X
Health providers awareness that their performance was being discussed at local council meetings			X		X
Health Administrators And Policy Makers
Relationships between individuals across levels of the health system				X	X
Non Governmental Organisation
Additional capacity building, credibility and visibility for non-governmental organisation					X
Cross-Cutting Implementation Considerations
Characteristics of tools
Posting information on free services and use of suggestion boxes were effective, in contrast to posters on patient’s rights and obligations which on their own were not effective			X
Simple checklists and indicators that reflect community experience and are observable by them			X	X
Strategic orientation
Working with communities and health workers to raise awareness of rights, rather than just one side			X		X
Fostering a common language, clarifying rules to counter power imbalances, fostering dialogue and mutual understanding, supporting a constructive rather than confrontational approach			X	X	X
Multi-level and multi-stakeholder initiatives that build synergies from household level interventions, community actions, health facility interventions to broader systems wide initiatives					X
Strategic planning and concrete operationalization
Situational analysis of community, health care system, local governance and higher level policy and management linkages;			X	X	X
Time and capacity-building of all stakeholders; Iterative processes to support changed attitudes and norms				X	X