Level | Factors affecting implementation of policy options included in the SURE Framework [15] | Factors affecting the implementation of role expansion for abortion care identified in this study |
---|---|---|
Recipients of care | Knowledge and skills | Â |
Attitudes regarding programme acceptability, appropriateness and credibility | Women’s attitudes to and experiences of different types of health workers | |
Motivation to change or adopt new behaviour | Â | |
Providers of care | Knowledge and skills | Health workers’ knowledge about abortion legislation and services |
Attitudes regarding programme acceptability, appropriateness and credibility | Health workers’ willingness to provide abortion care Health workers’ understanding and use of conscientious objection | |
Motivation to change or adopt new behaviour | Â | |
Other stakeholders | Knowledge and skills | Â |
Attitudes regarding programme acceptability, appropriateness and credibility | Co-workers’ attitudes towards role expansion | |
Motivation to change or adopt new behaviour | Â | |
Health system constraints | Accessibility of care | Â |
Financial resources | Â | |
Human resources | Â | |
Educational and training system, including recruitment and selection | Health worker training | |
Clinical supervision, support structures and guidelines | Health workers’ access to supervision and emotional support | |
Internal communication | Â | |
External communication | Â | |
Allocation of authority | Â | |
Accountability | Monitoring and evaluation of health workers | |
Community participation | Â | |
Management and/or leadership | Â | |
Information systems | Â | |
Scale of private sector care | Â | |
Facilities | Â | |
Patient flow processes | Health workers’ access to referral systems | |
Procurement and distribution systems | Health workers’ access to supply chains | |
Incentives | Health worker workloads and incentives | |
Bureaucracy | Â | |
Relationship with norms and standards | Â | |
Social and political constraints | Ideology | Â |
Governance | Â | |
Short-term thinking | Â | |
Contracts | Â | |
Legislation or regulation | Â | |
Donor policies | Â | |
Influential people | Â | |
Corruption | Â | |
Political stability and commitment | Â |