Table 4.

Summary of generated themes and codes/nodes

Thematic categories	Organising codes
Predisposition to self-refer
Understanding of healthcare delivery	First point of call: PHC facility Secondary health facility
	Role of PHC facility: An alternative facility to the secondary facility Closer to the people First aid and educational role Occasional and specific services
	Role of secondary health facility: Perceived as a process Referral facility Wider range of medical services
Enablers to self-refer
Access to the healthcare facility	Distance
	Opening and closing hours
	Service fees at secondary facility
	Socio-economic status
	Waiting time
Advice from friends, relatives and others	Influenced by relatives Influenced by friends
Expectations of service-users	Negative attitude from staff at PHC
	Time wasting going to PHC facility
	Lacked trust for healthcare providers in PHC Need for supervision of the facilities
Government regulations (policies)
Role of equipment or facilities	Absence of equipment or facilities at the PHC facilities
	Availability of basic equipment at the secondary healthcare facilities
	Lack of investigation prior treatment at PHC
Role of healthcare providers	Trained and qualified staff
	Lack of staff Level of knowledge of the staff at PHC facility
	Presence of doctors at the secondary facility
Need to self-refer
Level of severity	Mild
	Severe
Symptoms	Tiredness, stomach ache, feverish feeling, headaches