MaaCiwara is a randomised control trial in Mali (2021-24) run by Malian and UK university partners, evaluating a low-cost, community-level, behaviour-change intervention to reduce diarrhoea and malnutrition in children-under-five. As similar programmes have struggled to achieve lasting results, this intervention takes a novel 'positive-motivational' rather than 'disease-focused' approach, using locally-relevant performing arts (e.g. singing, dancing, storytelling, etc.), certification of mothers, peer-education and home-visits. The qualitative process evaluation (2023-24) explored ‘obstacles’ and ‘levers’ to implementation, and the role of performing arts in achieving project aims. This evaluation comprised 72 focus groups in 12 communities with around 400 beneficiaries, and observations. This intervention may initially look like a ‘top-down’ process with potential for clashes between project promoted behaviours, values and understandings of disease with ‘local’ notions. However, our findings suggest more nuanced processes. Here, we reflect on the theatre components’ scope to enhance local update/acceptance and its motivational potential. Overall, the intervention was well-received, participants recalled the intervention messages and saw merits/health benefits in applying them. Moreover, in several communities the vocabulary and imagery of the intervention are becoming the subject of Malian ‘joking’ kinship, thereby not only becoming embedded into daily language via jokes, stories, and singing intervention songs, but forming part of the production and reproduction of social bonds. Especially powerful/suggestive is the language and imagery relating to the two contrasting female characters which spectators emotionally connect and identify with: a mother applying the project-promoted standards of food hygiene and child nutrition and another (played by a man) who does not. This supports the findings of the project team’s realist review which demonstrated the effectiveness of theatre as a positive motivator in health projects primarily due to the emotional response they stimulate. Closer engagement with notions of acceptance/rejection is needed, addressing affective and socio-economic aspects and focusing on people’s agency.