Table 5.

Barriers to scaling up of health interventions

Community and household levels

Lack of information, women's education, physical, financial, women's decision‐making power

Health services delivery level

Shortage of qualified staff, weak technical guidance, programme management and supervision, inadequate supplies, equipment and infrastructure, poor accessibility

Health sector policy and strategic management level

Weak and centralized system for planning and management, weak drug policies and supply system, inadequate regulations, lack of intersectoral action and partnership, weak incentives to use inputs efficiently and respond to user needs and preferences, reliance on donor funding

Public policies cutting across sectors

Government bureaucracy, poor communication and transport infrastructure

Environmental characteristics

Governance and overall policy framework

Corruption, weak government, weak laws, political instability and insecurity, low priority to social sectors, weak structure for public accountability and opportunities for public opinions, lack of free press

Physical environment

Climatic and geographic predisposition, physical environment unfavourable to service delivery

Adapted from Ranson et al. (2003).