Angelina, another mother from a rural area in Zambézia, explained that nurses sometimes tell mothers to return home if their child is not bathed before a facility visit, noting that, “This happens all the time…[and] when it happens, everyone around them feels embarrassed by it.”

Getting the required health documents prepared in advance is also critical. Caregivers said that if a mother forgets the child’s vaccination card at home, health workers may send them back. This fear of judgment or rejection can discourage and demoralise caregivers from completing the vaccination process.

Finally, the caregiver must travel with the child to the health facility. Some caregivers are able to save enough money from selling food or other goods to pay for transport to the facility, while others may be brought to the facility by a relative on a motorbike or bicycle. For most caregivers, however, the only option is to carry the child and walk to the facility, even if it is 30 or 40 kilometres away. This journey is often over difficult and dangerous terrain, prompting many caregivers, the majority of whom are women, to try to travel in groups or seek accompaniment from a family member for safety.