Nutrition-sensitive agriculture (NSA) provides a promising pathway for addressing malnutrition. Fulfilling this promise needs a better understanding of the implementation and sustainability of NSA interventions because of their highly complex nature. This study aimed to explore the factors affecting the implementation and sustainability of NSA interventions. A case study design was employed using two focus group discussions with beneficiaries (n = 15), semi-structured interviews with beneficiaries (n = 13), and actors involved in implementation (n = 18). Factors were thematically analyzed using both deductive and inductive approaches adapting the consolidated framework for implementation research. A complex interaction of the factors across the five domains was found: outer setting—nutrition sensitivity of policies, institutional framework; inner setting—culture, social and economic environment, biophysical environment, local capacity, other programs or projects; characteristics of actors—beneficiaries, family members, household capacity, implementers; intervention characteristics—adaptability, design quality, cost of interventions; and, implementation process—fit-to-context, integration and multisectoral collaboration, continuous motivation through engagement, monitoring. Implementing and sustaining NSA needs consideration of multiple factors, with careful analysis of the absorptive capacities of local institutions and beneficiary households. Future studies should explore which mechanisms created for adoption can be continued beyond the project funding cycle, and how.

The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on phenomenology, a methodological approach to understand first-hand experiences, and grounded theory, an inductive approach to analyse data, where theoretical generalisations emerge. Data were collected through semi-structured interviews with pregnant women attending antenatal care services and healthcare workers (HCWs) in Barcelona, Spain. Interviews were audio-recorded, transcribed, and coded, and notes were taken. Inductive thematic analysis was performed, and data were manually coded. Pertussis was reported as the most trusted vaccine among pregnant women due to its long-standing background as a recommended vaccine in pregnancy. The influenza vaccine was regarded as less important since it was perceived to cause mild disease. The COVID-19 vaccine was the least trustworthy for pregnant women due to uncertainties about effectiveness, health effects in the mid- and long-term, the fast development of the vaccine mRNA technology, and the perceptions of limited data on vaccine safety. However, the necessity to be vaccinated was justified by pregnant women due to the exceptional circumstances of the COVID-19 pandemic. The recommendations provided by HCW and the established relationship between the HCW, particularly midwives, and pregnant women were the main factors affecting decision-making. The role of mass media was perceived as key to helping provide reliable messages about the need for vaccines during pregnancy. Overall, vaccines administered during pregnancy were perceived as great tools associated with better health and improved quality of life. Pregnancy was envisioned as a vulnerable period in women’s lives that required risk–benefits assessments for decision-making about maternal vaccinations. A holistic approach involving the community and society was considered crucial for health education regarding maternal vaccines in support of the work conducted by HCWs.