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