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Table 1 Perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative

From: From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province

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