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 |