Table 6.

Implementation of the by-laws

Rules	Material and non-material sanctions reported
Antenatal care visits	• Denial of care by health workers • Financial penalty issued by health worker for coming late to ANC (beyond three months)
Male involvement in ANC	• Chief refusing to write letter to excuse absence of husband • Women coming without husbands treated after women who are with husbands • Women who come alone sent back by health workers • MoH and UNICEF introduced a new award that health facilities can win if they increase the number of male ANC attendants
Institutional childbirth	• Payment in kind for home delivery (goat) • Financial penalty for home delivery ranging from MKW 6000 to 20,000 (USD 10–35) • Verbal insults to women who do not bring material, such as razors, soap and cloth, to the facility for their delivery