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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 (+/-)