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The second drive towards a facility focus is the broader organizational and system environment.
However, this facility focus runs counter to two key higher-level managerial expectations.
The main barriers to delivery at health centres were found to be the long distance from the health facility, payment for care and presence of male health worker at the health facility (focus group discussion and surveyor observations).
The manager needs to lead the meetings and give us direction on how we should be working in this clinic …. (a staff member at FM03's clinic) A combination of two key forces seems to drive the dominant facility focus of the FMs participating in this study: professional training and wider organizational and systemic factors.
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