Table 1 Themes, categories, codes, and formulated meanings
Theme | Categories | Final codes | Formulated meanings |
|---|---|---|---|
Health care provision system barriers | Lack of motivation | Low wages | It is challenging to manage livelihoods |
Job instability | There is a lack of stability in the employment situation of providers | ||
Ungratefulness | Health care providers have been ignored | ||
Lack of comprehensiveness in the Evaluation system | The payment system is based on quantitative performance | ||
Non-availability of facilities and doctors | Lack of equipment | Handling patients adequately is impossible due to a lack of equipment | |
Doctors’ shortage | The number of patients exceeds the number of doctors available to treat them | ||
Poor relationship between patients and providers | Communication is unimportant | There has been a lack of understanding in the health system about the importance of patient-provider relationships | |
Poor understanding of patients’ needs | Communications are more unilateral | ||
Disruption in the process | Poor collaboration | There is poor cooperation among health system workers | |
Work overload | The providers are responsible for a variety of tasks | ||
Paper work | Filling out forms is the main focus of health care providers | ||
Defective referral system | Neither patients nor providers are aligned with the referral system | ||
Coverage problems | Insurance inefficiency | High out of pocket | There are high payments by patients |
Insufficient coverage of health costs by the insurance | There is a high out-of-pocket expense | ||
Limited access | Benefit package limits | Various and required services are not usually provided | |
Overcrowding of free treatment centers | Queues are too long, reducing access at the right time | ||
Contextual barriers | Environmental problems | Unsafe environment | Refer to health centers is coupled with disturbs for women |
Unsuitable environment | The slums' architecture is unsuitable for the elderly to refer to health centers | ||
Socioeconomic barriers | Poor health literacy | There is a lack of information about the disease and its complications among patients | |
Poverty | It is difficult to access appropriate health care because of financial barriers |