She Needs Permission: Barriers and Enablers to Maternal and Reproductive Health Services

A clinic can exist and still be inaccessible when a woman cannot decide when to seek care, control transport money, move freely or obtain privacy. This qualitative work explored the conditions behind that gap. Participants described interacting barriers involving autonomy, knowledge, transport, finances, infrastructure, confidentiality, male involvement, cultural beliefs and traditional care pathways. The study shows why access is produced across household, community and health-system levels and cannot be reduced to service availability alone.