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Table 4 Summary of contextual factor findings

From: Factors influencing performance by contracted non-state providers implementing a basic package of health services in Afghanistan

Contextual factor

Features (positive (+) or negative (−) impact) affecting contracting-out

Sociocultural environment

• Ethnic and religious traditions and cultures (+/-)

• Traditional gender constructs (−)

• Social capital and culture of community participation (+)

Political, policy and legal environment

• Capacity and structure of provincial health departments (+/-)

• Influence of political leadership on hiring of staff and implementation of services (−)

• Conflict and insecurity (−)

• MoPH and central government’s enabling legal and policy environment (+)

Geography

• Accessibility of health services to population (+/-)

• Willingness of health professionals to serve in remote/insecure areas (+/-)

• Ease of access for supplies (+/-)

• Ease of access for monitoring (+/-)