Table 3 Main themes and subthemes for barriers and weaknesses of pre-pregnancy care services

Clients Factors

• Unaware of the services

• Family Commitments

• Do not understand health care providers

• Accessibility to nearest health care facility

• Unwilling to plan for pregnancy

• Unplanned pregnancy

• Patient attending clinic not for PPC

• Patient aware, but refuse to utilise service

• Distance from home

• Accessibility to nearest facility

• Socio-economic status

• Women’s perception

• Husband’s acceptance

• Religiously not permitted

• Time constraint

Services factors

• Lack of facilities at rural clinics

• Health care attitudes towards clients

• Lack of discussion between health care providers and clients

• Unconducive environment

• Untrained staff

• Lack of resources

• Lack of privacy

• Longer stay in clinic

• Lack of collaboration

• Disorganised system