Factors | Facilitator | Barrier |
---|---|---|
Planning Phase | ||
Environment | ||
1. Financial situation | ✓ | |
2. Government support including champions | ✓ | |
3. Changes in abortion law | ✓ | |
4. Limited capacity of health system | ✓ | |
5. Wavering support for TBAs | ✓ | |
Innovation | ||
1. Clear, concise, well-defined | ✓ | |
2. Adaptation of criteria | ✓ | |
3. Flow of distribution | ✓ | |
User Organization | ||
1. MOH Central | ✓ | |
2. MOH MNCH health staff | ✓ | ✓ |
3. MOH pharmacists | ✓ | |
4. APE (dependent on TBA relationship and distance) | ✓ | ✓ |
5. TBA recruitment (close to health facility) | ✓ | |
Resource Team | ||
1. Members | ✓ | ✓ |
2. Existence of SWAp MNCH Technical Working Group | ✓ | |
3. SWAp MNCH Technical Working Group irregularity of meetings | ✓ | |
Management Phase | ||
Type of Scale-Up | ||
1. Horizontal (phased expansion) | ✓ | |
2. Limited sites in each district (5 health facilities in selected districts) | ✓ | |
3. Untrained health staff due to mobility | ✓ | |
4. Vertical (institutionalization) | ✓ | |
Dissemination and Advocacy | ✓ | |
1. Development of National PPH Strategy | ✓ | |
2. Communication of PPH Strategy | ✓ | |
3. Training of health staff, APEs, and TBAs | ✓ | ✓ |
Organizational Process | ||
1. MOH Central | ✓ | |
2. MOH Provincial | ✓ | ✓ |
3. MOH District | ✓ | |
Costs/Resource Mobilization | ||
1. Available Budget | ✓ | |
Outcomes | ||
1. Utilization and access in Nampula province | ✓ | |
2. Utilization and access in Inhambane province | ✓ | |
3. Logistics system | ✓ |
Abbreviations: APE, Agentes Polivalentes Elementares (community health worker); MNCH, maternal, newborn, and child health; MOH, Ministry of Health; PPH, postpartum hemorrhage; SWAp, Sector Wide Approach; TBA, traditional birth attendant; WHO, World Health Organization.