Table 1 Themes from the qualitative analysis

Scheduling system initially challenging

Managers—No existing system for scheduling patient visits. There was a learning curve for accepting its need and using it effectively

Women not reachable

Midwives—Women do not always have phones, many unreachable

Midwives like checklists

Midwives—Midwives stated that checklists were helpful and had adapted them for onsite care

Midwives busy

Midwives—Added to an already busy workload, would like to have less documentation responsibility

Managers—Daily scheduling needed to ensure compliance

Client provider relationship building

Midwives—Calling clients keeps them connected

Managers––Helps to realize existing government initiatives

Women—Women felt comfortable calling the midwife for problems

More service utilization

Midwives/Managers—Women are more likely to come for services after phone calls

Managers—Because of the phone calls more women are coming for ANC and PNC

Women—We know the midwife and feel more comfortable visiting the health center

Avoidance of unnecessary hospital visits

Midwives—Phone calls help women to feel safe at home

Managers—During COVID 19 telemedicine helps women avoid exposure

Women—Midwives provided reassurance around common complaints

Linking high-risk women to services

Midwives—Telemedicine is very helpful to identify problems and encourage care

Women—Midwife provides reminders of danger signs and answers our questions. When needed they encourage us to seek care

Community reluctance to speak about GBV but may be more comfortable on the phone than in person

Midwives—Midwives state women are reluctant to speak about GBV during phone interviews, but still they disclose more on the phone than face-to-face

Managers—Women are reluctant to talk about GBV face-to-face but more are disclosing using telemedicine