Table 1 SURE framework for identifying factors affecting implementation of a policy
Level | Factors affecting implementation |
|---|---|
Recipients of care | Knowledge and skills |
Attitudes regarding program acceptability, appropriateness and credibility | |
Motivation to change or adopt new behavior | |
Providers of care | Knowledge and skills |
Attitudes regarding program acceptability, appropriateness and credibility | |
Motivation to change or adopt new behavior | |
Other stakeholders (including other healthcare providers, community health committees, community leaders, program managers, donors, policy makers and opinion leaders) | Knowledge and skills |
Attitudes regarding program acceptability, appropriateness and credibility | |
Motivation to change or adopt new behavior | |
Health system constraints | Accessibility of care |
Financial resources | |
Human resources | |
Educational system | |
Clinical supervision | |
Internal communication | |
External communication | |
Allocation of authority | |
Accountability | |
Management and or leadership | |
Information systems | |
Facilities | |
Patient flow processes | |
Procurement and distribution systems | |
Incentives | |
Bureaucracy | |
Relationship with norms and standards | |
Social and political constraints | Ideology |
Short-term thinking | |
Contracts | |
Legislation or regulations | |
Donor policies | |
Influential people | |
Corruption | |
Political stability |