Table 3.

Challenges associated with the structure of FPP

Theme	Subtheme	Categories
Legal structure	Laws and regulations	Incomprehensive and unclear rules
		Cumbersome laws
		Failure to comply with the rules
	Policy making	Lack of trans-sectoral perspective in health care policy making
		Writing the program’s executive protocol with a one-dimensional view
		Use of a top-down approach instead of a participatory approach
		Prioritize the organizational perspective over the technical perspective
		Lack of research in developing policy
		Treatment-based instead of health-based approach
Administrative structure		Lack of a united stewardship and governance system in the health system for the FPP and fragmentation in policy making in the field of health
		Lack of cooperation
		Role conflict and ambiguity between different sectors and stakeholders
		Lack of continuity in the program leadership
		Leadership issue
		Quality control
		Medicalization of management
		Competing interest
		Educational issues
		Lack of a specified monitoring system
		Inadequate efforts to facilitate the necessary cultural shift toward adoption of FPP
Social structure		Insufficient attempts of public educational systems and mass media such as TV to promote FPP
		Neglecting culture building and lack of acculturation