Table 1 Coding frame

Peer Support

Peer-support as a maternal health-enabler

Supported promoted dialogue

Dialogue helped challenge and re-evaluate inaccurate stereotypes and harmful clichés

Dialogue enabled sharing information regarding best practices during maternal care

Dialogue gave rise to empathy and availability of strong friendship ties with people in similar situation

Provided of support to peers

Peer support promoted emotional, psychological, physical and economic support among HIV positive women during maternity

Promoted treatment-adherence

Peer support encouraged regular and consistent uptake of ARVs before and after birth

Peer support served as a continuous reminder for uptake of ARVs

Fostered alliances

Peer support allows for the formation of alliances among peers to advocate for an end to sexual cleansing

Working together to fight stigma and discrimination through advocacy and other means

Fighting patriarchy and promoting women empowerment

Peer support as a maternal-health inhibitor

Re-enforced superstition regarding institutional-delivery

Peers reinforced the negative superstition regarding health facilities e.g. Clinics practice witchcraft and infant deaths for ritual purposes etc.

Reinforced a sense of helplessness and dependency

Experiencing and seeing fellow peers’ ill outcomes reinforces helplessness and hopelessness in others

Promoted harmful sexual practices

Promoting Traditional practice of dry sex

Promoting Sexual cleansing

Use of indigenous resources

Utilization of indigenous resources as a maternal health-enabler

Trained TBAs provided support

Provide pragmatic services in the form of psychological and emotional support

Provide adherence-to-treatment support

Help in providing priority attention to HIV positive women upon recommendation at the facility

Provide continuous home-based maternal care

Trained TBAs provided maternal health information

Provide useful maternal health information

Trained TBAs as a conduit for referrals

Help to refer patients to facilities

Provide transportation support for women to go to facilities

Utilization of indigenous resources as a maternal health-inhibitor

TBAs obscured institutional delivery

Presence of TBAs prevents people from seeking professional help

Presence of TBAs prevents government from improving insertional care

TBAs lacked skills, equipment and medical supplies to handle complications

TBAs lack skills to Help in PMTCT

TBAs lack skills to Help Easily conduct HIV tests

TBAs lack skills to Help in the provision of ARVs

TBAs cannot Help in conducting caesarian births

community involvement

Community involvement as a maternal health-enabler

Promoted use of Zambulance

Use of Zambulance to transport pregnant mothers to facilities for antenatal, childbirth and postnatal care

Zambulance help to provide utility transportation services for drugs in difficult terrains

Promoted use of ‘waiting shelter’ (shelters where expectant mothers can stay while they await delivery.)

Provision of safe spaces for discussing best ways of providing shelter to pregnant women and new mothers

Provision of care and support to other women within the community through the shelters

Use of local leaders and other significant people in communities to promote use of shelters

Provision of nutrition and other supplies necessary during child birth in shelters

Provision of mosquito nets to prevent HIV positive women against Malaria

Encourage uptake of institutional delivery among HIV positive women

Work together with others to encourage other HIV positive mothers seek antenatal and postnatal care

community involvement as a maternal health-inhibitor

Reinforced tokenism

Community involvement was just symbolic as it failed to actively and realistically involve locals

Reinforced negative power relations

More powerful NGOs and health workers obscured the voices of the weak and vulnerable