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Table 4 Implementation and Routinisation

From: Determinants of an integrated public health approach: the implementation process of Greenland’s second public health program

Enabling determinants

Constraining determinants

• Adopters across levels agree that they have a shared responsibility for the implementation of Inuuneritta II

• “When everyone has the responsibility, then no one has it.” (HC4)

• Overall operational coordination lies with the Ministry of Health

• Budget is divided into topic areas

• Initiation of the central prevention committee (CPC) ensuring intersectoral collaboration

• CPC meetings are inconsistent in context and participation of members

• Collaboration across ministries has not been politically prioritised neither within ministries

• The CPC does not collaborate with nor monitor LPCs

• Public-private partnerships have been initiated by health consultants

• Stakeholders of public-private partnerships are not held accountable

• Inuuneritta is part of local health policies

• High turnover of employees in the Ministry of Health

• The few well-functioning local prevention committees (LPC) support the work of CHWs

• CHWs lack a coordinating body

• Language barriers between CHWs and HCs constrain vertical communication

 

• Lack of human resources in the Ministry of Health and locally in municipalities