Fig. 2.

A conceptual model of access to care (62, 86). Elements of the eligibility to access concept (62) were applied to the thematic analysis of the narratives gained in Study 2. The analysis revealed a hierarchical arrangement of the relevance of the dimensions of access, whereby the organisation of health systems dictates service provision, and provider and service user behaviours, i.e. the locus of control over eligibility for access to care, lies within the macro-level operating conditions of the health system. A reciprocal effect was also identified whereby the behaviours and attitudes of service users’ feedback into the operating conditions, maintaining the social norms that shape exclusion from access.