Table 2. Barriers to Participation for Vulnerable Women in Health Sector Priority Setting .

Category of Barrier	Barriers to Participation	Identified by	Illustrative Example(s)
Financial	Transport (distance/cost)	• DHMT • Rural women	“I don’t reach to the higher-level meetings… I don’t always attend because it is difficult for me to reach there, it is far” (Iteso, 59).
	Lack of incentives/compensation for time	• Sub-county leaders • Rural women	“They should be given something for motivation and if others see this, they will be encouraged to attend the meetings” (Japadhola, 80).
Biomedical and/or health	Illness/Disability	• All	“I was willing to continue [participating] but I have a problem with my leg I cannot walk easily” (Japadhola, 80).
	Menstruation	• Rural women	“Sometimes when I am in my menstruation period, I stay at home … (due to) absence of pads [sanitary napkins]… I miss, I don’t go” (Japadhola, 16).
Knowledge-based	Lack of education (knowledge/literacy)	• All	“So even if you go there you find people who come who ended in P.7[seven years of schooling], S.4 [eleven years of schooling], S.2 [nine years of schooling] and for you who have never gone to any level you can understand anything” (Iteso, 57). “If the person cannot read and write or speak English because it (the meeting) is conducted in English, most times the woman in the village, does not get that opportunity” (DHMT member).
	Lack of information about participation (rights/opportunities)	• All	“Because they are not informed, they cannot know that a meeting is going to take place, but if they were informed, they would go” (Japadhola, 52).
Motivational	Perceived laziness/disinterest	• Sub-county leaders • Rural women	“People in the village are lazy” (Iteso, 16). “People who are drunk are married to alcohol, they don’t want to listen to the chairman or to the people who come” (Iteso, 59).
	Competing needs/time commitments	• All	“Women from the village cannot go to the sub-county, because there are competing time needs like; digging, cooking … for me who is a widow, I have a lot of responsibility” (Iteso, 57).
	Lack of feedback/follow through	• Sub-county leaders • Rural women	“Things are supposed to be here (in the village) but they don’t reach to people at their homes, sometimes you hear that they have given out things like medicines, but here people don’t get them … they should not just come once and never come back, they should always be coming” (Iteso, 30). “Personally, my idea is that whatever has been discussed should not remain here, it should be put in practice” (Japadhola, 18).
Socio-cultural	Lack of decision-making power	• All	“You may find women may be too interested in being involved but they can’t come or their husbands do not allow them to come in for the meetings so it’s more of the power relation bit in a home where the man says I am going to attend the meeting, you don’t need to go” (Sub-county leader). “Culturally the women are not supposed to attend the meetings. Culturally, the woman is not supposed to be heard” (DHMT member).
Structural	Hunger	• All	“When somebody comes trying to ask them questions and if someone slept hungry, they will not be able to talk to you” (Iteso, 50).
	Poverty	• All	“The very poor, when you tell them to come, they [may] attend meetings but after the meeting … they want something [money]” (Iteso, 60).

Abbreviation: DHMT, district health management team.