Table 1.

Identified Themes and Categories Condensed From Meaning Units on Providers’ View of the Transplant Center in Ethiopia.

Meaning units	Codes	Categories	Main themes
I believe every department in the center should have been well structured and organized Both critical care and Post OP beds are around in the same area, I think that should be managed Water, machines, medicines and some supplies were in short supply initially How much skilled man power do you have, how many beds do you need to place, and what actual number of patients are you planning to admit or give a service to	Poor organization No plan No plan	Gaps on organization and system planning	Challenges experienced during and after launching the center
People are not equipped with up-to-date special training on transplantation services, most are selected from the main hospital The gap was due to the lack of studying every challenge to come and opportunity earlier, the house was rented, there was no generator initially It was only limited number of people who have been trained, that was a challenges and source of frustration during the time A special person to procure the items may be necessary, sometimes, items might not be obtained through a planned regular procurement process We are also limited to the number of services to be delivered, the capacity we had is a rate-limiting factor	No training No personnel Knowledge gap No personnel Low capacity	Challenges related to personnel and capacity building
When you request listed items, PFSA (Pharmaceuticals Fund and Supply Agency) in Ethiopia may respond but we have no reserves to tackle with shortages or lead time needs Some items, such as stitches, reagents and supplies might be in short supply I suggest a permanent system to be established for sustained availability There were only few suppliers to collect input bid for some startup materials	Supply uncertainties Limited supply Trusted source Few suppliers	Challenges related to suppliers
I suggest the government arrange homes especially for those from the countryside There are costs related to medication, diet, and transplantation Because all patients are not rich, costs even after 2 months and, those coming while on their follow up may suffer from the challenges	High rental costs Costs Unaffordable costs	Patients’ capacity to afford costs
One possible challenge I experienced from transplantation is setting the issue of finding a donor Donor should be from relatives and be compatible in all aspects I noted the main challenge facing during transplantation was lack of a donor Those being volunteer may fail due to the incompatibility of their blood Your donor mainly matters; compatibility tests, and other processes till patient reaches post OP stage	No donor Donor Lack of donor Lack of donor Donor matters	Challenges related to donor
The space is limited for providing services by all professionals I have a fear that the center is ready well to satisfy all needs to arise in the future We have more patients waiting for the service, and that may require 2 months to complete we do not have adequate beds	Limited space Unmet need High patient load Limited space	Unmatched demand and supply
Everyone in the center feels stressed throughout the care, because all want that patient recover from surgery I could prefer to do more scrub of other surgery than 1 renal transplant. It is tedious and intensive	Stressful Tedious	Demand for commitment	Commitment, sympathy and satisfaction
I believe the professional team is motivated despite incentive issues We mourn with those searching for donors, and strive to help those with donors amid of less attractive incentive packages The big satisfaction is to see a patient cured that has been suffering on dialysis	Professionalism Share feeling Share feeling	The sympathy of providers
People are happy for the service they get here They say they are back to work, they say they are free from dialysis costs	Satisfaction Lowered cost	Providers’ view on patients’ satisfaction
Dialysis may require 15000-20000 birr per month, but in transplant they might need 4000birr on average for the first month Because you may need to go for 3-4 times per week in dialysis, this may include family costs to care, even immunosuppressant drug costs could be better than service by dialysis	Low cost Low cost	Economic outcomes	Outcomes of renal transplant
You will see people with good quality of life and they learn each other about their life changes After 4 months, they will be advised to commence their work	Improved quality Productivity	Clinical and humanistic outcomes
Even though there was no proper plan to premise standards, we sat and discussed with physicians on the needs to be fulfilled We get ready of everything before 1 week of the procedure	Discussion Preparation		Actions taken to improve quality of service
I have a fear that the center is equipped well to cover all needs to arise in the future Stakeholders, particularly, the ministry of health, and PFSA need to collaborate intensively as time goes on	Concern Engagement	Need for an active engagement of stakeholders	How the transplant center should operate
Those with low income may still suffer as they have to cover their costs I suggest the government arrange homes especially for those from the countryside The government must also make sure that drugs are readily available in public sectors like the ‘Kenema’ (public) pharmacies	High cost Seek support Availability and affordability	Continuity of support to patients
Still more is needed to be done for meeting international standards Assuring the availability of reagents and medications should be mandatory as this cannot be stopped once started	Standard Availability	Sustaining the service in the center