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Table 1 Definitions of contributors and challenges to successful strengthening of service delivery systems using CFIR constructs

From: How service delivery implementation strategies can contribute to attaining universal health coverage: lessons from polio eradication using an implementation science approach

Internal contributors
Individual characteristics High levels of individual knowledge, self-efficacy, higher likelihood to provide sustained support through stages of change and good perception of the organization
Organizational settings Clear organizational structure with adequate personnel, strong formal and informal communication networks, healthy organizational culture, presence of leadership readiness for implementation
GPEI program characteristics Perception of internal vs external source of the interventions, perception of evidence strength and quality, relative advantage of polio program vs other programs, trialability, perceived complexity of implementation, design quality, costs of implementation and opportunity costs
Process of conducting the activities Stages of the implementation process: detailed planning, engaging with relevant stakeholders, good execution of activities, established mechanisms for monitoring and evaluating program progress and quality
External contributors
Political Political climate accepting of polio eradication activities, political structure conducive to coordinated action
Economic Sufficient revenue to fund activities
Social Social norms around immunization in communities where polio eradication activities were implemented
Technological Infrastructure or technological advances
Implementation challenges: consisted of internal and external contributors that impeded national and subnational implementation of the polio program
Individual characteristics Low levels of individual knowledge, lack of self-efficacy, lower likelihood to provide sustained support through stages of change and poor perception of the organization
Organizational settings Weak organizational structure with inadequate personnel, limited formal and informal communication networks, poor organizational culture, absence of leadership readiness for implementation
GPEI program characteristics Perception of internal vs external source of the interventions, perception of evidence strength and quality, relative advantage of polio program vs other programs, trialability, perceived complexity of implementation, design quality, costs of implementation and opportunity costs
Process of conducting the activities Stages of the implementation process: lack of advanced planning, challenges of attracting and engaging with relevant stakeholders, poor execution of activities, difficulty with monitoring and evaluating program progress and quality
External settings Challenges related to the external political, economic, social, and technological environments
  1. Source: Alonge et al. Synthesis and translation of research and innovational from polio eradication (STRIPE): initial findings from a global mixed methods study. BMC Public Health 20, 1176 (2020). https://doi.org/10.1186/s12889-020-09156-9