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 |