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. 2019 Mar 8;14(3):e0213388. doi: 10.1371/journal.pone.0213388

Table 3. Facilitators and barriers of implementation perceived by providers.

Facilitators

  • Job aids and supportive protocols

  • New knowledge and skills

  • Perceived increase in the accuracy of EDDs

  • Independence for nurse-midwives vs. reliance on sonographer

  • Collective problem-solving and discussions

  • Dedicated nurse-midwife performing gestational dating ultrasounds

  • Prompt identification of high-risk clients and referrals

  • Standardization of clinical practices

  • Ultrasound scan provided at no cost

  • Novelty of gestational dating services in geographical area

  • New equipment

Barriers

  • Need to adapt clinical workflow

  • Insufficient training and practice on ultrasound performance

  • Lack of knowledge about importance/utility of standards

  • Low motivation and no financial incentives for providers

  • Staffing shortages

  • Long queues for gestational dating ultrasound creating added pressure for provider

  • Additional documentation requirements

  • Late first ANC visits by clients