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Table 3 Linkages between the third order themes, triggers, drivers and consequences

From: Manifestations and drivers of mistreatment of women during childbirth in Kenya: implications for measurement and developing interventions

Third order themes Immediate triggers Underlying drivers Consequences of event
Physical abuse Desire to save lives Normalization
Frustration of health providers associated with broader health system constraint/environment
Gender inequalities and inadequate understanding of individual rights
Deter future facility delivery
Verbal abuse Negative patient outcomes triggering some form of reprimand
Desire to save lives
Normalization
Complex legal redress mechanisms
Frustration of health providers due to health system constraints- weak governance structures and accountability
Deter future facility delivery
Stigma and discrimination Multiparous women
Geographical location of women- poor neighborhoods/dress code
Age –young teenagers
Surnames
HIV status
Broader community and societal/social economic challenges
Tribalism
Lack of knowledge or of patients’ rights
By passing nearest facilities leading to potential morbidities and mortalities associated with delays during self-referrals
Deter future facility use
Failure to meet professional standards of care Multiparous women
Geographical location of women- poor neighborhoods/dress code
Age –young teenagers
Health system drivers- Human resource challenges, weak legal and policy implementation
Broader social cultural norms
By passing near facilities leading to potential morbidities and mortalities associated with delays during self-referrals
Deter future facility use
Poor rapport between women and health providers Geographical location of women-poor neighborhoods/dress code Health system drivers- Human resource challenges
Tribalism
By passing nearest facilities leading to morbidities and mortality associated with delays during self-referrals
Deter future facility use