Table 5. Factors That Influenced Doctors’ Attitudes and Actions at Primary Health Centers.

Label	Details	Underlying Beliefs
Profession-related factors	The primary health center was not perceived as a place for good clinical work- since it had few drugs and equipment to work with. Primary care roles were perceived as hindering professional growth. Doctors’ roles in primary health centers was perceived as reduced to being that of administrators and social workers, leading to a lack of professional satisfaction. Doctors felt professionally isolated in primary health centers.	Perceived lack of professional value in executing primary care roles. Did not want to work in public systems; preferred the private sector. Public sector jobs needed one to be risk-averse. Mistrust and lack of connect with rural patients. Other personal values.
Organizational factors	Perceived structural deterrents at primary health centers Limited facilities and drugs, poor infrastructure. Vertical programs that functioned with strong targets. Lack of adequate support staff for outreach. Non-structural organizational issues “Narrow” mandates to provide only certain services. Too many targets were imposed by higher-ups. Emphasis on reporting rather than doing “good” work. Some doctors felt that they had little actual authority over outreach staff-even as heads of these centers. Doctors had low confidence that authorities in the system would support them in case of mishaps.
Other socio-political factors	Doctors felt they could do little for patients due to the constraints of drugs and equipment they faced. Doctors reported facing clinically irrational demands from patients. Local politicians demanded preferential services. Reports of violence against doctors engendered fear.