Category of barriers | Countries | Keys barriers and evidence |
---|---|---|
Leadership and governance | Zambia, Senegal, Malawi | Poor integration of services, poor accountability [16] |
Tanzania | ||
Tanzania | Policy factors and slow decentralization processes for programme management [12, 14, 15] | |
Health financing | Zambia, Senegal, Malawi | Budgetary allocation [16] |
Tanzania | Out-of-pocket expenditure [13] | |
Human resources | Nigeria | Lack of health worker training on existing recommendations |
Incorrect knowledge [20] | ||
Tanzania | Under-staffing, | |
Inadequate skills | ||
Poor motivation [13] | ||
Tanzania | Unfriendly supervision | |
Limited training opportunities [14] | ||
Products, infrastructure and logistics | Tanzania, Zambia | |
Service delivery | Tanzania, Zambia | Long distance, long waiting time, ineffective |
Poor organization of educational services and lack of explanation to patients | ||
Failure to link intervention with benefits | ||
Nigeria | ||
Tanzania¸Uganda | ||
Zambia, Malawi, Senegal | Inadequate supervision of service delivery [16] | |
Tanzania | Low rate of administration of IPTp by health workers at ANC [12] | |
Information systems | Tanzania |