Table 4.

Themes and sub-themes from thematic analysis of responses.

Themes and sub-themes
Provision of care themes
Evidence-based practices
Low availability of, and adherence to, protocols and guidelines
Actionable information systems
Medical records absent for outpatient children; confidentiality not protected
Routine care not adequately documented
Functional referral system
Referrals necessary for sophisticated care beyond initial facility capacities
Poor referral communication
Referrals complicated by transportation deficits
Experience of care themes
Effective communication between provider and patient
Some patients satisfied with provider guidance, for example, breastfeeding, danger signs
Variability in degree to which providers were transparent and supportive to patients
Permission and informed consent not consistent
Respectful care and preservation of dignity
Focus on parent-newborn unity and parent involvement not consistent across facilities
No consistent policy/practice on parent-newborn unity
Respect for family members varied by facility and staff member; impacted by high patient load
Emotional support of families
Staff support provided to emotional RDW varied by facility and by individual staff
Cross-cutting themes
Competent and motivated human resources
Shortages of trained staff and specialists
Under-incentivized and overworked staff
Variable staff supervision
Essential physical resources
Deficits in equipment/supplies, medication, space, water, electricity, infrastructure at all facility levels
Emergent theme affecting experience of care
Financial insecurity
Parents’ perception of cost for transport, services, medication resulted in delays or refusals