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According to Dr. Bielby, the key is "analyzing and reforming processes for making human resources decisions" and creating accountability for implementation and enforcement of those reforms.
Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread.
However, despite the existence of a supportive legal environment, there is a notable lack of accountability for implementation.
Factors impeding spread included resource constraints, unclear responsibility for funding and accountability for implementation, and pre-existing ways of providing palliative care.
Direct accountability for implementation was assigned by the policy to public health care professionals who believed in the initiative and had been advocates for its adoption.
Accountability for implementation may differ by jurisdiction and organization depending on the health care system and how guideline programs are funded.
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Dr. Kim was an early adopter of the data-driven approaches and rigorous evaluations that identify what works best in development and build accountability for their implementation.
(Senior leader #11) Ambiguous responsibility for funding IPC carried over into unclear accountability for program implementation, which some leaders said impeded spread.
In contrast to Brazil, the absence of a rich history of social movements and participation in health policy-making and political accountability for policy implementation complicated the Global Fund's ability to deepen health governance in China.
As with HIV/AIDs and other issues, the African Union can be an important stakeholder in promoting commitments to improve the health of women and children and ensuring accountability for their implementation.
Central coordination under government stewardship, which can be enhanced through establishment of a national TB policy committee, should ensure the development of a national strategic plan for TB elimination embedded in national health and social sector plans, and accountability for its implementation.
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