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Table 3 Internal and external contributors and implementation challenges of strengthening service delivery across respondents

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

Biggest internal contributor to health services delivery strengthening activities (n = 848) Freq. (%) Illustrative Example
 Process of conducting activities 408 (48.11%) Specific strategies to systematically reach difficult populations, including microplanning
 Individual characteristics 157 (18.51%) Motivated and knowledgeable health workers and volunteers
 Organizational settings 148 (17.45%) Collaboration and effective coordination among NGOs, government, and donors
Polio program characteristics 135 (15.92%) Relative ease of storing and administering OPV
Biggest external contributor to health services delivery strengthening activities (n = 843)
 Social environment 358 (42.47%) High levels of trust and community awareness towards health workers and vaccines
 Political environment 221 (26.22%) Strong political leadership and support, overall peace and stability in the country
 Economic environment 167 (19.81%) Sufficient and timely funding
 Technological environment 79 (9.37%) Expansion of mobile phone networks enhanced coordination and delivery
 Other environment 18 (2.14%) Accessible geographies
Challenges to strengthening health service delivery (n = 830)
 External settings 463 (55.78%) Security challenges, community resistance
 Implementation 187 (22.53%) Lack of adaptation to meet local needs and context
 Individual 82 (9.88%) Lack of confidence or motivation among health workers
 Organizational 62 (7.47%) Competing priorities, and lack of accountability mechanisms
 Polio program-related 36 (4.34%) National immunization days and supplementary immunization activities do not support routine immunization