Tab. V.

The challenges of the Iranian health system in fighting COVID-19; other factors.

Themes	Line-managers	Staff-managers	Sub-themes and related codes
Factors related to the people and patients	✓	✓	Delayed treatment of patients with other diseases and the consequent complications due to not going to the hospital in pandemic condition
	✓	✓	The people’s fear of the disease
	✓	✓	Inobservance of health protocols by some of the people and patients
		✓	The people’s tiredness of observing the protocols and the decreased social resilience
Factors related to the disease	✓	✓	Factors related to the disease nature	New and unknown nature of the disease and its symptoms and complications
	✓	✓		The changed behavior of the virus and impossibility of predicting the disease
		✓		The high transmission rate of the disease
		✓		The long incubation period
		✓		Person-to-person transmission of the disease
	✓	✓	Factors that are effective in provision of high quality services in hospitals	Impossibility of providing face-to-face clinical education for the people and patients
	✓	✓		The coronavirus patients’ referring to hospitals simultaneous with other diseases
	✓	✓		The large population of patients
	✓			The people’s expectations from health workers for service provision
	✓			The impacts to other routine services
	✓	✓		Decreased quality of service provision
	✓			The increased workload in laundry and the volume of hospital waste
		✓		The limited time for preparing the personnel for reception of the patients