Table 2 Participants’ viewpoints about Barriers to community participation in primary health care of district health

Community trust in the health system

Community distrust in participatory programs

Community distrust in health programs

Status of community participation programs

Not defining a specific position for community participation at different levels of the health system

Community and system’s perception of participation programs

Community misperception of participation programs’ importance

Staff misperception of participation programs’ importance

Health personnel’s distrust in community’s abilities

Health system management approaches

Centralized and cumbersome structure in decision-making

Lack of attention to long-term plans by managers

Lack of responsiveness channels in community participation

Lack of paths and mechanisms to attract community participation

Non-cooperation of other stakeholder governmental organizations in community participation

Cultural barriers and institutional obstacles

Cultural barriers to community participation

Institutional problems in people’s lives

Lack of workforce and financial resources