Table 3 Interview guide questions

Predisposing

From your understanding, can you tell me about the functions of the primary healthcare facilities (small clinics)?

Can you also tell me about the functions of the secondary healthcare facilities (general hospitals)?

Which level of healthcare facility (primary, secondary or tertiary) is supposed to be your first point of contact when you have any health problem? (Why do you think the facility should be your first point of contact?)

Enabling

Have you attended the PHC facility (small government clinic) in the past for any reason?

-If no, is there any particular reason that made you avoid using them?

-If yes, what was your experience using the facility/ services?

Additional question for patients who had used the PHC facilities in the past; are there reasons that have prevented you from going back to the PHC facility for your current medical condition?

How did you come to know about the secondary healthcare facility you attended? What do you think about the services provided by the secondary healthcare facility?

What are the reasons responsible for you and other patients preferring to come directly to the secondary health facility (general hospital) rather than use the primary healthcare facility?

Can you tell me more about other factors that you think might make patients directly present to the secondary healthcare facility (general hospital)? (Probing for the roles of opening hours, waiting time, transport, fees, healthcare providers, service provided if not mentioned)

From your view as a service-user what are the likely things that will encourage you and other service-users to use the PHC facilities?

Need

What medical problem/condition brought you to the secondary healthcare facility (general hospital)?

What was your thought about the problem/ what did you think was going on? (Probing for the perception of the seriousness of their condition)

Did you think this problem cannot be managed at the primary healthcare facilities? Why?