Table 4.

Sustainable Health systems adaptations suggested by respondents

Themes	Emerging subthemes	Examples
Service delivery	IPC infrastructure	“There are other interventions on personal hygiene, you know, we had taps, all the buildings, we built taps in front of a lot of our facilities, so we ensure that people still carry out personal hygiene and the health talks in relation to the facilities” (SS)
	Telehealth Infrastructure	“.Then the call centre, you know we have the COVID-19 call centres and there is need to also allow it to continue beyond the pandemic to a general health call centre. That will be one of the legacies of the pandemic.” (NC)
	IPC protocols	“.we keep on emphasizing and encouraging people to use it particularly in public places.”(NC) “.we should still use the PPEs and the donors, the partners should not still run away you know” (SE) “All the changes [IPC] we made, are changes that should continue to be used….” (NC)
	Service re-organization: IPC teams	“…At every health facility, be it primary or secondary, there is an IPC focal person whom was not there before the pandemic. So, we now have an IPC focal person at the various health facilities that are now active.”(NC) “Yeah, okay so, the IPC teams are still in place, those ones are still in place. Of course, we will continue to do the training like you mentioned, yes of course, we will continue to do that” (SS)
	Service re-organization: task shifting	“We will continue to ensure that our facilities carry out something that we said during the pandemic: peer mentoring, task shifting and task sharing.”
Medicines and supplies	Provision of PPEs	“Provision of PPEs should be done constantly on a monthly basis so that there is no time that you get there (health facilities) that you won’t see them [health workers] practicing these IPC….” (SW)
Human resources	Training on IPC	“You know the IPC strategy gives training on personal hygiene, personal protection and all that, I think going forward, that should be enhanced…” (SE) “The IPC training structure was set up for each facility and network electronic platform set up to allow them collaborate is something that should be maintained because generally IPC is important not just for COVID-19 even for normal infection like diarrhoea. The IPC practices, I think is something that needs to continue.” (NC)
	Capacity building	“…We had different types of training, training upon training during this period and then people are used to it and people are likely to continue doing it. it has been like a habit, a very good habit.” (SW)
Information	Public sensitization and community engagement	“Sensitization has increased and has come to stay. Also, it has also helped in quick supply of the necessary materials by the health centers.” (SW) “And then the community engagement side for demand generation, we will also continue, it will not stop, so a lot of those groups that were formed as a result of COVID-19, they are still in existence, so we will still work with them to make sure that we use them for other interventions, going forward.” (SS)
	Virtual meetings	“At the State level now, some of the changes that were made for example, if we want to do meeting now, it is not compulsory we do physical meeting…” (SW) “.there were more virtual meetings than during the pre-pandemic. It is something to hold to.” (NC)