Table 6.

Themes, categories, and codes describing the perceptions by stakeholders and physicians concerning factors influencing IMCI implementation in Matiari district, Sindh, Pakistan

Themes	Categories	Codes
Factors supporting IMCI implementation	Knowledge and perception about IMCI strategy Separate under-five clinic at PHC facilities	Holistic approach Practical and useful Significant strategy Improved child health Best option Facilitate implementation Designated provider Better attention Better management
Factors constraining IMCI implementation	Lack of clear understanding of IMCI strategy Lack of planning for IMCI implementation Ambiguity in roles and responsibilities toward IMCI implementation IMCI – a time-consuming task Emphasis on training vs. logistic support Lack of monitoring and supervisory mechanism Inefficient referral system	Unclear understanding Program for infants only Lack of knowledge Unclear with objective No planning Emphasis on training Poor planning Non-involvement of pediatricians Uncertainty Communication gap Lacked awareness Unclear role No guidance received No job description Helplessness Emphasized MNCH program to assist Non-involvement How to monitor What to do Increase patient flow Problematic to practice More time needed More documentation Disagreement by stakeholders More attention on training Absence of supplies Unavailability of drugs Restrict practice No counseling cards, chart booklets and recording forms Issues in purchase of medicines No supervision Expressed need for supervision Lack of district facilitators’ training Assessment of recording forms Weak referral system Lack of feedback Lack of transport Financial constraints Unavailable referral slips