Table 1.

Highlights from the focus group discussions and in-depth interviews included in the socio-ecological model.

Level on the socio-ecological model	Factors	Quotes
The intrapersonal and interpersonal level	Socioeconomic status	“While pregnant and to take her, the biggest obstacle would be money. If there is no money how do we take? Many want to go but if there is no money, how can we? That’s the biggest difficulty we face in village. Those who have, they can, but those who do not then that’s the problem and that’s how they do not take them and deliver at home.”- Liangmai man, 38 years old
	Sense of confidence and self-esteem	“Me, I am not clever, and we are nothing right?” – Liangmai woman, 35 years old
	Fear of the individual and the community	“So, for women, giving birth is the toughest thing. It is like sitting on the edge of the cemetery.” – Liangmai woman, 27 years old
	Traditions and myths	“My grandmother always said: you should not go anywhere, and you do this and that ok? (…) When we are pregnant our stomach should be properly hidden. Our stomach should not be open. That is the advice of the elders which we know, from our experience. Means, they say that bad things are seen through it. When we get pregnant our stomach should be covered very nicely and should not be allowed to be seen.” – Young Liangmai pregnant woman
		“Giving birth is a battle of life, during delivering whether a woman will live or die. Before our forefathers left us with this saying. A pregnant or women after deliveries should be taken good care because they fight for their lives and whether they live or die they do not know.” – Liangmai male partner, 38 years old
	Religion and trust kinships	“Because when we go to doctors and they cannot do, we ask God for the help and His direction. Because God knows everything. So, God shows the direction on how to go and do.” – Liangmai woman, 28 years old
		“More than doctors. I trust God more. Prayers.” – Liangmai woman, 31 years old
	Family and spouse	“If a woman is getting a baby, then the full responsibility should be on the father, a husband should take care of everything.” – Liangmai husband, 30 years old
	Perception of biomedical services	“So we will go to the hospital… that’s the last resource or else no other way.” – Liangmai man, 24 years old
	Role of family as sources of knowledge	“We get advice from the elder people. Like from my mom and dad. What’s the best thing(s) that we should do? Like for our health issues. They will just give us the advice: “Do like that.” And then we will go” – Liangmai man, 30 years old
The community, organizational, and policy level	Community health workers	“When pregnant, our families, husbands also, or brothers-sister… suppose, to me, I should not go alone. ASHA is there, colony’s ASHA is there. ASHA takes you and will take you (referring to the health facility)” – Liangmai woman, 35 years old
	Faith based organizations	“We, after birth do not have anything to do…We take it to the church, we do this only” – Liangmai woman, 37 years old
	Public health strategies	“In our report, we write for more hospital deliveries. Home delivery is more, but because the women wants to get the money, because we they are told to give birth in the PHC. It is difficult for us to take them also. So, even if the delivery is at home we write as delivery in the hospital. We lie because they will not get money, right? The JSY and all.” – ASHA, 41 years old
	Health professionals perspective	“We do not have proper light also, we do not have electricity, we do not have mobile network also, we are facing problems” – Doctor