Table 1

Perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative

Component

Major issues

Program resources and logistics

*Poor condition of cold chain in all aspects

*Poor skills and authority in resource allocation and human resource management

*Limited advocacy and communication resources

Technical aspects

*Deficient skills and training among staff at all levels in almost all aspects of the program

Program operation, management and organization

*Deficiency of public health professionals and poor health services structure

*Administrative issues including:

*ineffective means of performance evaluation,

*bureaucratic and political influences,

*problems in vaccination area and field program,

*lack of immunization cards,

*no birth records at health facilities, and

*poor linkage between different preventive programs

Monitoring, evaluation and feedback

*Unreliable reporting and poor monitoring systems

*Limited use of local data for interventions

*Unclear roles and responsibilities after decentralization

Mushtaq et al. BMC International Health and Human Rights 2010 10:22   doi:10.1186/1472-698X-10-22