Facilitators | Barriers | Recommendations | |
---|---|---|---|
Health Workforce | - Hiring of qualified local people along with incentives for retention | - Unpredictable security conditions | - Hire more female staff and reduce gender imbalance |
- Security threats | - Send female staff on rotation basis to conflict areas | ||
- Lack of female health workers | - Provide adequate training | ||
- Absenteeism and lack of capacity of healthcare staff | - Provide housing and basic necessities | ||
- - Low salaries | - Merit based hiring | ||
- Absence of accommodation and basic facilities for doctors | - Doctors or staff to provide replacements when going on leave | ||
- Quacks (traditional or religious healers) are preferred by people over doctors | |||
Service Delivery | - BPHS and EPHS has improved service delivery (through contracting out) | - Non-functional healthcare facilities | - SOPs should be implemented |
- Changing demographic pattern | - Work on infrastructure for the uptake of health care intervention | ||
- Establishment of various new primary healthcare facilities | - No services in remote areas | ||
- Lack of HIV prevention program, orthopedic care, dental care, laboratory and screening tests and emergency care | - Stringent monitoring mechanisms using technology | ||
- Improve community awareness and mobilization activities | |||
- Poor infrastructure | - Improving CMWs functionality | ||
Supplies and Commodities | - Different donors provide different supplies and services | - Short budget allocation on supplies | -Procurement decisions at the province level |
- Enough supplies were provided | - Conflict blocked supplies to the facilities | - Procurement systems to simplified and made efficient | |
- Supply of fake medicines and documentation | - Strict monitoring | ||
- Allocation of budget for medicines not revised according to present needs | - Stringent quality checks | ||
- Absence of diagnostic facilities | |||
Monitoring and Reporting | - Developed SOPs | - Poor quality of data | - Promote E-Health |
- Encourage third party monitoring | - Preference of manual work over computer use | - Improve quality of data | |
- EHIS system for reporting | - Capacity gap | - Do situational analysis before implementation | |
-Data to be used for decision | |||
Finances | - Donor dependent funding | - Insufficient funds | - To ensure sustainability of funding for existing programs |
- Delay in release of funds from the donors | |||
- Poor practice of budget allocation and improper utilization of funds |