Table 2

Characteristics of included qualitative studies

Study	Country	Study aims	Participants’ characteristics	Study design and data collection	Aspects of D&A explored*
Chen et al54	China	To explore coverage, quality of care, reasons for not receiving care and barriers to providing postnatal care after introduction of new policy.	Caregivers of children younger than 2 years of age and township maternal and child healthcare workers.	Mixed methods combining a quantitative household survey and qualitative semi-structured interviews.	Health system level issues such as workload, income and training.
Dol et al62	Tanzania	To explore the experience of newborn care discharge education at a national hospital in Dar es Salaam, Tanzania from the perspective of mothers and nurse midwives.	Mothers who recently gave birth at national hospital and nurse midwives working on the postnatal and labour ward.	Qualitative descriptive research using in-depth interviews.	Woman-provider communication, and social, institutional and cultural influences when providing care.
Ganle and Dery63	Ghana	To explore the barriers to and opportunities for men’s involvement in maternal healthcare in the Upper West Region of Ghana.	Men and their spouses, community chiefs, women leaders, assembly men, community health nurses, community health officers and mother-to-mother support group leaders.	Qualitative focus group discussions, in-depth interviews and key informant interviews.	Challenges to male involvement in maternal healthcare, including institutional constraints and providers attitudes.
Kane et al64	Sudan	To gain insight into what hinders women from using maternal health services.	Community members, traditional leaders and traditional birth attendants.	Qualitative focus group discussions and in-depth interviews.	Social fears, social expectations and social interactions.
Mahiti et al65	Tanzania	To explore women’s views about the maternal health services (pregnancy, delivery and postpartum period) that they received at health facilities in rural Tanzania.	Women attending a health facility for vaccination at Kongwa District Hospital and Ugogoni Health Centre.	Qualitative focus group discussions and non-participant observation.	Women-provider interaction, waiting times, informal payments and material constraints (drug shortage and dirtiness).
McMahon et al66	Tanzania	To explore how rural Tanzanian women and their male partners describe disrespect and abuse experienced during childbirth in facilities and how they respond to abuse in the short or long-term.	Women, male partners, community health workers (CHWs) and community leaders from eight health centres across four districts.	Qualitative, cross-sectional study using in-depth interviews.	Types of verbal and physical abuse, discriminatory treatment, unpredictable financial charges and fear of detention.
Melberg et al67	Burkina Faso	To explore how communities in rural Burkina Faso perceive the promotion and delivery of facility pregnancy and birth care, and how this promotion influences health-seeking behaviour.	Women with recent health centre birth, women with a recent home birth, their partners and community men and women.	In-depth interviews and focus group discussions.	Fear of reprimands, economic sanctions, denial of care, stigma and discriminatory practices.
Mselle et al59	Tanzania	To examine how postpartum care was delivered in three postnatal healthcare clinics in Dar es Salaam, Tanzania.	Nurse-midwives and obstetricians from Dar es Salaam Referral Regional Hospitals.	Semi-structured interviews.	Relations of power among providers and women, focusing on beliefs, values, practices, language, meaning.
Morgan et al68	Uganda	To understand the role of gender power relations in relation to access to resources, division of labour, social norms and decision-making affect maternal healthcare access and utilisation in Uganda.	Women who had given birth recently, fathers whose wives had given birth recently, and transport drivers.	Qualitative focus group discussions.	Access to resources, division of labour (including male involvement), and social norms (including health workers attitudes and behaviours).
Ochieng and Odhiambo69	Kenya	To understand what factors are leading to low healthcare seeking during pregnancy, childbirth and postnatal period in Siaya County in Kenya.	Women attending ANC in Kenyan public primary healthcare facilities.	Qualitative focus group discussions.	Transportation issues, affordability, attitudes of health providers, embarrassment, autonomy in decision making, denial of care or punishment for delaying care.
Ongolly and Bukachi55	Kenya	To explore the barriers to men’s involvement in antenatal and postnatal care in Butula subcounty, Western Kenya.	Married men of the Butula subcounty who had had children in the past 1 year and healthcare workers in charge of maternal health services.	Mixed methods using quantitative surveys, focus group discussions and key informant interviews.	Health systems barriers including long waiting limes, lack of privacy, infrastructure constraints and providers’ attitudes.
Probandari et al56	Indonesia	To explore barriers to utilisation of postnatal care at the village level in Klaten district, Central Java Province, Indonesia.	Mothers with postnatal complications, family members and village midwives.	Qualitative data using in-depth interviews.	Suboptimal patient-centred care including lack of communication, availability of providers, insufficient time, inadequate education, selective care, cultural beliefs and practices, social power.
Sialubanje et al60	Zambia	To identify psychosocial and environmental factors contributing to low utilisation of maternal healthcare services in Kalomo, Zambia.	Women of reproductive age (15–45 years) who gave birth within the last year, traditional leaders, mothers, fathers, community health workers and nurse-midwives.	Qualitative focus group discussions and in-depth interviews.	Provider’s attitude such as verbal abuse and health systems constraints.
Sacks et al15	Uganda and Zambia	To examine experiences with, and barriers to, accessing postnatal care services in the context of a maternal health initiative.	Women who had delivered in the preceding year and lived within the eight districts.	Qualitative focus group discussions.	Fear of verbal or physical abuse, fear of denial of care or threat of denial of care, and neglect.
Yakong et al57	Ghana	To describe rural women’s perspectives on their experiences in seeking reproductive care from professional nurses.	Women 15 and 49 years of age and who had received care from two rural clinics and clinic nurses and community-based surveillance volunteers.	Qualitative study with in-depth interviews, focus group discussions and participant observation.	Intimidation and verbal abuse, experiences of limited choices, of receiving silent treatment and of lack of privacy.
Yevoo et al58	Ghana	To explore ‘how’ and ‘why’ pregnant women in Ghana control their past obstetric and reproductive information as they interact with providers at their first antenatal visit, and how this influences providers’ decision-making at the time and in subsequent care encounters.	Pregnant women who were within a gestational age of between 12 and 20 weeks and focus group discussions with pregnant and postnatal women.	Ethnographic study using participant observation, semi-structured interviews, and focus group discussions.	Healthcare providers’ ideological ‘domination and humiliation, including derogatory comments and verbal abuse, stigmatisation and discrimination, privacy and confidentiality.
Zamawe et al61	Malawi	To examine the perceptions of parents toward the postpartum period and postnatal care in order to deepen the understanding of the maternal care-seeking practices after childbirth.	Women and men who had either given birth or fathered a baby within 12 months prior to the study (new parents).	Descriptive qualitative study using focus group discussions.	Health system constraints related to long waiting times, costs, distance.

*The information presented in this column has been extracted during the initial coding phase of the qualitative analysis. No explicite conceptual definition of D&A was provided in most of the included studies.
D&A, disrespect and abuse.