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Table 1 SURE framework for identifying factors affecting implementation of a policy

From: Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol

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
  1. Adopted from “The SURE Collaboration, 2011” World Health Organization