1. SURE framework for identifying factors affecting implementation of a policy^a.

Level	Factors affecting implementation
Recipients of care	Knowledge and skills
	Attitudes regarding programme acceptability, appropriateness and credibility
	Motivation to change or adopt new behaviour
Providers of care	Knowledge and skills
	Attitudes regarding program acceptability, appropriateness and credibility
	Motivation to change or adopt new behaviour
Other stakeholders (including other healthcare providers, community health committees, community leaders, programme managers, donors, policymakers and opinion leaders)	Knowledge and skills
	Attitudes regarding program acceptability, appropriateness and credibility
	Motivation to change or adopt new behaviour
Health system constraints	Accessibility of care
	Financial resources
	Human resources
	Educational system
	Clinical supervision
	Internal communication
	External communication
	Allocation of authority
	Accountability
	Management or leadership, or both
	Information systems
	Facilities
	Patient flow processes
	Procurement and distribution systems
	Incentives
	Bureaucracy
	Relationship with norms and standards
Social and political constraints	Ideology
	Short‐term thinking
	Contracts
	Legislation or regulations
	Donor policies
	Influential people
	Corruption
	Political stability

^aAdopted from SURE Collaboration 2011.