Even when facilities exist, the poor are bewildered or turned off by the way they are treated. Or they simply may not know about the existence of the facility or how to get to it.
For example, a 1981 survey of a major city in South Asia showed that not one child was immunized adequately with the DPT and polio vaccines; only a few were protected against measles and the majority went without immunization of any kind. The children surveyed were all attending government-aided nurseries, for which government aided grants provided for periodic visits of medical professionals, and there was a primary health care centre in the neighbourhood.