Table 3.

Thematic and content analysis: Findings from Soweto.

Thematic Heading	Description	Content
Knowledge of maternal immunisation	Pregnant women receiving immunization. Immunization of mothers. Giving mothers injections.	‘It is to prevent diseases whilst the woman is still pregnant’ – FGD, Mothers. ‘It's all about preventing infections that can affect a baby’ – pregnant mother. ‘I think you are talking about the mother being immunized. Immunization refers to injections’ – non-pregnant woman. ‘Maternal is mother then immunisation is where by a mother like myself, she takes her child to the clinic to get their vaccines’ - Doula. ‘I think they take pills that prevent the baby from getting HIV if the mother is HIV positive. It's a pill of some sort’ – pregnant mother.
Knowledge of types of maternal immunization	Tetanus/ATT or Pertussis or Flu vaccine	We give pregnant mothers tetanus when they first book at the clinic’ – midwife. ‘The flu vaccine is given once when they come to book, but obviously if the pregnant mother has got the signs of flu’ – midwife. ‘I don't know of any’ – pregnant mother. ‘According to my experience I haven't seen one, even when my wife was still getting children there was no immunisation that was given to her on behalf of the baby’ – FGD, fathers. ‘I did not receive any vaccinations during my pregnancy. But I know of the vaccination that prevents a baby from getting HIV’ – mother, GBS positive.
Uptake & Use of maternal immunisation	Tetanus/ATT or Pertussis or Flu vaccine	‘I received some injections during my pregnancies but I do not know what they were for’ – pregnant woman. ‘I was never vaccinated. They just did the normal procedure like HIV test, that's the only thing I can remember’ – mother, GBS positive. ‘I don't remember getting any vaccination during my pregnancy. I just remember that they took some blood from me to do some tests' – pregnant woman. ‘During my pregnancy I received the flu vaccine. I don't remember receiving any other one – pregnant woman’. ‘I received only one vaccination when I was pregnant. They told me that it was for my discharge or something like that. It was an injection’ – non-pregnant woman. ‘I was attending the Chiawelo clinic, I know they vaccinated us. The first injection they gave me, they said if my blood and the babies are not same group, it shouldn't affect the baby, something like that and they injected me with that’ – non pregnant woman. ‘I have been vaccinated before but I don't know the name of the vaccine’ – pregnant woman.
Attitudes	Positive or pro immunization during pregnancy Negative or anti-immunization during pregnancy	‘Pregnant women come to the clinic and just go with the flow of what the sister is saying’ – midwife. ‘The thing is sometimes when we are given vaccines we don't ask what we are being given. You find that they just administered’ – pregnant woman. ‘‘I remember the flu vaccine. I have never heard of tetanus. Truly speaking, I also did not ask the nurses anything when I was pregnant’ – non pregnant woman.
Beliefs and misconceptions	Thoughts/perceptions about immunization Cultural perceptions Religious perceptions Myths	‘I have never come across a case where women object immunization because of religious beliefs’ –midwife. ‘I didn't take the flu vaccine because two years ago my sister received the flu vaccine from Bara. She was fine during the pregnancy but after she delivered the baby she got such a strong and bad flu – pregnant mother’. ‘Immunization is one of the ways the government uses to control people’ – FGD, men ‘In my Xhosa culture there are certain illnesses that they encourage us not to go to the clinic for. That instead we must use traditional medicine until I am fine – pregnant mother. ‘They need to explain to me the importance because when a person is pregnant, she doesn't just take anything. Even if you get flu or you have a headache you don't drink any medication’ – mother, GBS positive. ‘My main fear is that what if the nurses do not vaccinate us for the correct thing. How do we know that they are vaccinating us for the correct thing? That makes me fearful’ – pregnant mother.
Acceptability of maternal immunization	Intension to make use of vaccination Encouraging pregnant women to be immunized	‘With my first pregnancy I was a bit more concerned about taking things while I am pregnant. I just feared that by taking things then my child would not be okay. I worried about the side effects of taking medication and what if they affected the baby’ – pregnant mother. ‘I encourage it because if you are not taking that injection to get that immunisation it means that you putting the baby on the risk because you won't know on the day you deliver what problems you will encounter and the baby will be affected’ – Community leader. ‘I think especially since we normally say prevention in better than cure, so for preventative methods so if there could be any viruses that the baby could pick up because the mother has not been immunised- Counsellor
Factors affecting future use immunizations	Socio-economic Socio-political	‘I think the question of unemployment is a serious problem in our country’ – Counsellor. ‘Vaccination should always be free. If there was a cost, then as for the mom who goes to the clinic it would be a problem because some are unemployed or stay at home moms, some don't even have money and others are single’ – Doula ‘It comes back to cost because even if the vaccine is available and I do not have the money to get it then I will not be able to get it – pregnant mother.