| Barriers hindering pregnant women from accessing health care | • Women have to seek approval from an authority figure to access health care. |
| • Weak women were perceived to deliver at the hospital and strong women at home. |
| • Community members lacked knowledge about pregnancy danger signs. |
| Barriers at the community health facility level | • Poorly equipped health facilities: “We have to give birth on cement floors because there is only one bed …” |
| • Limited access to drugs: “We need medicines, we need our hospitals to be repaired …” |
| • Limited access to health personnel, especially female personnel: “The male CHEWs are afraid of touching us …”; “[Female CHEWs] should be available in the facility at all times, not coming from time to time …” |
| • No emergency transport to Jahun General Hospital: “The roads are bad and the hospital a long distance away … transportation is too high [costly] and if the only available car has gone to the market, that is all …” |
| Barriers at the referral facility level | • Perceived negative outcomes to delivering at Jahun General Hospital: “If CHEWs referred us to Jahun General Hospital, we will not really be happy to hear that …” |
| • Feeling insulted and harassed by staff at Jahun General Hospital: “They ignore us and call us villagers …” |