Table 5.

The themes, subthemes, and representative quotes.

Theme	Subthemes	Representative Quote(s)
Population	Knowledge	‘For existing programmes (child vaccination), there is a rejection from a particular group. They said vaccination is not important. This is due to a lack of knowledge and awareness about vaccination. In addition, some mothers were afraid of the side effects of vaccination, such as fever’ (Transcript 11).
	Cultural norms and vaccine controversy	‘There are cultural differences between Aceh and Yogyakarta (which affect the vaccination program). For example, the vaccination (coverage) of children in Aceh is low because of public perceptions. They feel that people health is a gift from God. In addition, the controversy about the issue of Halal and Haram related to vaccine ingredients (containing pork) or Jewish conspiracies. All of these issues impacted vaccination coverage’ (Transcript 4). In my opinion, people in Gunungkidul and are still easily driven by certain figures. We still have a king. If the king says, we are still obedient to carry out it. But, I think it’s not the same with outside Yogyakarta province. Our society is still easy to move, believe in the leadership, and easy to be directed to in accordance with government programmes (Transcript 7).
Governance	Policies: regulation	‘Currently, the hepatitis B vaccination programme provided by the government is still limited to children, and its coverage is still low...where most of the adult population is susceptible to hepatitis B infection. Therefore, further vaccination is needed for the adult population in Indonesia; at least the community knows about hepatitis B vaccination for adults’ and can access it’ (Transcript 5).
	Financing	‘Currently, Indonesia has two vaccination programmes, namely the national and elective programmes. Hepatitis B vaccination for adults is an optional programme. So, for adults who want to receive hepatitis B vaccination, they seek vaccination and pay for it themselves’ (Transcript 2).
	Insurance and purchasing
	Trustworthy data	‘Yes indeed, this is some of the homework that we must do. That is true; our data (related to hepatitis B) are still minimal. So that is why there are recommendations in our planning from the committee expert, one our target (has to improve) is reporting’ (Transcript 12).
Platforms	Geographic access to facilities	‘As far as I know, there are some hard-to-reach areas in Indonesia that we (MoH in Jakarta) might be unable to monitor very well. For example, in Papua, implementing a hepatitis B birth dose (HB0) that should be given less than 24 h might be difficult due to geographic conditions. Some gave HB0 seven days after delivery’ (Transcript 2).
Workforce	Managers: number and distribution	‘We have a lack of human resources. Most of them handle more than one programme. For example, surveillance and Hajj. In addition, some of our staff have already retired’ (Transcript 11).
	Skill	‘There is no other staff with a health promotion background in Gunungkidul Regency except me. So, this can be an obstacle to improving our programme. In addition, we only have one staff member for administration and data analysis. We need more staff with the proper skill to achieve our programme’ (Transcript 7).
	Teamwork	‘We collaborated with other sectors. Usually, we involve the Ministry of Religion, Youth and Sports Office and cadres to educate the community about the benefit of vaccination and vaccine implementation’ (Transcript 11).
Tools	Hardware: equipment	‘We need a tool for disseminating information that uses the local language so that local people can understand the message’ (Transcript 3).
	Information system	‘We would like to develop culture-based dissemination, for example, Wayang cakruk. This medium will reach many layers in our community. It still really likes this Wayang segmentation. We believe that the traditions that exist and only exist in Gunungkidul can convey the message from us (health providers). However, this is an expensive medium due to its use of many instruments’ (Transcript 7).