<p>(Domain 1): Intervention characteristics.</p>

Using NVivo Version 14.0 software, we managed and analysed all interviews to explore facilitators and barriers to the implementation of G-ANC. Data were grouped and reported according to their relevance to the CFIR constructs. Implementation of G-ANC was shaped by interacting factors across all CFIR domains.

Key facilitators included the perceived relative advantage of G-ANC over conventional ANC, adaptability of the model to local contexts, supportive facility leadership, effective teamwork, and peer support among women. Similarly, implementation processes such as proper scheduling of group sessions supported continuity of G-ANC services. In addition, the positive experiences of community health workers (CHWs), HCPs and pregnant women reinforced sustained implementation.

Major barriers included inadequate space for meetings, workforce shortages, competing clinical demands, socioeconomic constraints and privacy concerns in group settings. Successful implementation of G-ANC in low-resource settings requires alignment between intervention design, health system capacity, and community context. Addressing multilevel barriers while strengthening identified facilitators is critical for the successful adoption of G-ANC and its integration into other maternal and newborn health services.</p></div>