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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


187 (22.53%)

Lack of adaptation to meet local needs and context


82 (9.88%)

Lack of confidence or motivation among health workers


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