Table 7.

Enablers and challenges in implementing the COVID-19 vaccination program from key informants.

	Enablers	Challenges
Leadership	Robust political commitment, clear direction, and collaborative approach across government institutions. Regular supervision and direct support provided at implementation level.	(N/A)
Human resources	Strong sense of motivation and urgency among staff to make the program a success. Large numbers of volunteers mobilized thanks to the emergency context. Skilled and experienced personnel in the routine immunization program were leveraged to support COVID-19 vaccination.	Complex recruitment process meant that sites could not hire new staff to support COVID-19 vaccination. Program had to solely rely on the existing health workforce and volunteers. Human resource gaps, specifically at temporary sites, placed immense pressure on existing staff to meet the high demand for vaccination.
Financing	Timely financial and in-kind contributions from development partners for activities such as cold chain rentals and training. Off-budget financing mechanisms for partner funding helped facilitate activities that required sizable upfront investments, such as mass campaigns.	Limited funding at implementation level for essentials such as social mobilization and transport. Honorarium for staff discontinued, impeding staff morale and their commitment to the program. Rigid public financial management mechanisms hindered timely disbursement of government funds.
Supply and cold chain	(N/A)	Supply constraints when the program launched and short expiry dates for vaccines. Limited space and equipment to manage temperature-sensitive vaccines at the site level.
Social mobilization	Existing high levels of trust for the routine immunization program within communities.	(N/A)