the lack of poorfriendly services at the facilities is another major factor impeding access to services the health service institutions particularly the public facilities are allegedly not poorfriendly for a few reasons in part the service providers are not properly educated about patients rights as this vital component is missing from the medical training curricula doctors are also apathetic about their duties due to low salaries and a lack of incentives another reason may be that the facilities are overcrowded due to the lack of a referral system which overburdens the providers