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)

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

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 provider knowledge about patients’ rights

X

Health providers awareness that their performance was being discussed at local council meetings

X

X

Relationships between individuals across levels of the health system

X

X

Additional capacity building, credibility and visibility for non-governmental organisation

X

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

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

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