Table 4

Outcomes of interventions based on parent/guardian and service provider comments

Intervention	Outcomes	Parent/guardian/service provider quote
Weekly radio sessions	Encouraged people to attend clinic	‘They are useful because there are people who don’t come to the clinic so it might encourage them to come to the clinic’ (Clinic C, parent/guardian 5).
	Educated regarding importance of immunisation	‘…some of [the parents] when I come [to the clinic]… they said… ‘I overhear from the radio that immunisation is very important that is why I came here’ (Clinic B, CCW 2).
	Allowed for feedback to be provided to clinics Encouraged service quality improvement	‘…they are so amazing because we used to get a good feedback of the kinds of things but we also used to get the bad feedback… it’s very important for us to get the bad feedback, that’s where we're going to try to raise our socks up’ (Clinic A, clerk 1).
	Built relationship between parents/guardians attending clinics and service providers	…it was a nice feeling to have the staff from this facility going to the radio… the clients feel so good because they know this person who speaks on the radio… on the Tuesday that she’s going to do the talks, [the nurse] was standing [in the waiting area] and telling [the parents] that ‘I’ll be doing the talk on the radio, you must listen’… others are coming with their earphones in case they are still here by that time, they would listen… we had one of our clients, she opened the radio and then she puts on the mic, and that way everybody would listen when she talks… (Clinic B, facility manager).
	Addressed gap in health promotion activities	…we have NGOs that are dealing with the other diseases like your HIV, TB, cancer and other ones, but immunisation it’s very rare to find organisations that are dealing with that. So, it was really helpful for our people, and we know that in black communities some parents may not take it seriously, that they have to take their kids for immunisation to the clinics… So, they need to know that information which is going to be helpful for their kids… (Radio staff 1).
	Introduced the possibility of expansion for other clinics from around Cape Town to be involved	‘…this idea of rotation from different clinics can help… not only Khayelitsha. Because the questions that [parents] used to ask… these nurse that they used to come here… were not able to tackle… because they are not working there’ (Radio staff 2).
Nurse-led health talks	Educated regarding importance of immunisation Allowed for linkage with other interventions that were implemented	‘[the nurse] was talking about the importance of immunisation and what you must do if you are bringing your child for immunisation. She even showed us a chart talking about the effects of not immunising your child’ (Clinic B, parent/guardian 5).
Nurse-led health talks	Encouraged dialogue between parents/guardians and service providers Fostered an environment where parents/guardians acted as health promoters to the community	They ask the question, and then we answer those questions… they are used to talk to us to visit those people for those child who are not updated with their immunisation… Even the seniors… that hear the information… they go back to their homes with that information that are given at the clinic (Clinic B, CCW 1).
Service provider and parent quality checklists	Encouraged service quality improvement	…it is good because it is like a link between a clinic and the person so whoever is doing the survey will take it to the facility manager, and when there is this survey the clinic is going very quick…’ (Clinic C, CCW 1).
	Allowed for feedback to be provided to clinics	Initially, when they [the parents] were asked do you know… [and if] they didn’t know… I found that, ‘okay, this is the area where I should put emphasis on with the education’… those feedbacks… they help us to know where we should focus our talks…it was one of our tools to evaluate this [information] that we are giving out, does it sink well or need to put more… emphasis on that certain topic…so I think it a good thing to evaluate (Clinic A, facility manager).
	Not used to their full capacity during implementation period	‘They were not utilised effectively. I think that it’s not mandatory from the officers… people don’t take it seriously… Or if there is no one that is monitoring it, that is making sure you tick, please, you return the [checklist]’ (Clinic C, deputy facility manager).
Health promotion materials	Used as a supplementary information source to road to health card/booklet	‘I have seen this, I remember they were there by the security and each and every parent was taking from there, and to their road to health cards there are others that are stapled on their cards’ (Clinic C, CCW 4).
Health promotion materials	Simplified educational information	Sometimes [parents] are lazy to read if it just a black and white. So, because there were nicely printed in colour and they’ve got the pictures as well, so they were well presented. Even if you don’t like to read, but the colour will draw you to just watch and read. And the information inside there was very good and it was simple and anyone can understand. (Clinic A, facility manager).