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Table 3 Organizational or system and health center level factors for the Implementation of ANC model

From: Challenges and opportunities for implementing evidence-based antenatal care in Mozambique: a qualitative study

Factor

Main barrier

System or organizational factors

Supply chain

Fragmentation due to multiplicity of supply chains and sub-supply chains

Lack of coordination between levels

Lack of knowledge of the procurement and supply chain management concept

Lack of qualified personnel with experience in supply management

Lack of protocols

Lack of reliable data for supply management

Deficiencies on storage system

Difficulties for the distribution due to transportation deficiencies

Audit and Supervision

Lack of regular supervision and monitoring visits affects the care provided

Health care providers continuing education system

Limited impact of the existing training models on ANC model

Human Resources at health center level

Staff shortage

Staff turnover

High workload

Goods and products at health center level

Lack of supplies

Environment conditions at HC level

Lack of appropriate infrastructure to conduct the interventions of the package in an integrated way

Patient Data Record System at health center level

Deficiencies on record system regarding patients’ information

 

Absence of training on data collection

 

Lack of data collection forms

 

Data recording fragmentation and duplication

 

Deficiencies on data analysis

Factors related to the health providers knowledge, skills and attitudes

Health providers knowledge and skills

Lack of awareness on guidelines and protocols implementation

Health care provider attitudes

Resistance to follow the procedures