Table 4.

Themes.

Themes	Barriers
Transportation	Distance [28,29,30,32,33,34,37,38,39] Weather and poor roads [28,29,30,33,34,40] Security [28,35,39] Lack of ambulance service [30,32]
Culture and beliefs	Traditions and beliefs [28,30,32,33,35,37,39] Lack of belief in or limited knowledge of benefits of maternal healthcare [28,29,30,32,33,34,35,39] Lack of women’s autonomy [28,31,33,35,38,40]
Family support	Domestic chores and family obligations [28,30,35,37] Lack of husband’s support [28,30,32,33,37,39,40]
Economic factors	Cost of maternal care and transportation [28,29,30,33,34,35,37,38,39,40]
Quality of care	Lack of proper infrastructure [28,29,33,37] Insufficiently experienced providers [31,34,35,37,39] Disrespect and abuse [28,29,31,32,34,36] Language barriers [36]