Table 2.

Sub-themes and themes nested to socio-ecological model constructs.

Sub-themes	Themes	Socio-ecological model
Misperceptions about maternity services	Low maternity healthcare-seeking behaviors	Intrapersonal level
Low perceived care quality and mistrust in providers
Low health-literacy and self-efficacy
Low women’s autonomy	Lack of peer/family support	Interpersonal level
High women’s workload and responsibilities
Family/peer pressure against maternity care
Low male’s involvement
Intimate partner violence
Cultural influence on pregnancy disclosure	Cultural influence on maternity services and low community’s responsiveness	Community level
Cultural rule of first-childbirth experience
Cultural influence on postnatal care
Low social accountability
Delays in accessing ambulance service	In adequate health system readiness and response	Health facility/system level
Excessive waiting times for maternity care
Shortage of essential healthcare supplies
Inconvenient health facility environment
Lack of coordination for maternity care
Inadequate transportation infrastructure
Insufficient monitoring and evaluation
Unsafe security conditions
Disrespectful maternity care
Health workers’ dissatisfaction