Table 1.

Perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative

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