The introduction of contextual information and legal rules in service contracts introduces many challenges in service adaptation during service rediscovery process.
With a shift in musculoskeletal physiotherapy from secondary to primary care in Ireland, this study aimed to explore physiotherapists' experiences of providing musculoskeletal physiotherapy in primary care to gain an insight into their changing roles, challenges in service delivery and continuing professional development (CPD) needs.
The reductions in the number of funded positions, described by participants in this study, further exacerbated challenges in service provision capacity.
Some of the inherent challenges in service provision included difficulties in recruiting and retaining a skilled workforce, maintaining and extending health infrastructure, ensuring service quality and safety with a small population base, and ensuring affordability.
Our findings uphold earlier work by Blaise and Kegels [ 35], who describe the rigidity and lack of responsiveness in command-and-control structures observed in several African health systems as contributors to quality of care challenges in service delivery.
The model offers a framework for bringing representatives from existing community networks, CTC providers, and health facility staff together to form a community team charged with identifying challenges in service delivery, testing solutions, and monitoring changes.
It is a key challenge in health service management to understand, analyse and exploit the role of key agents who have the capacity to connect disparate groupings in larger systems.
It is a key challenge in health service management to understand, analyse and exploit the role of key agents who have the capacity to connect disparate groupings in larger systems [ 4].
It was clear that challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly.
