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Other guidance advocates a person centred approach encompassing tenets of PBS which leads to environments capable to deal with such behaviour and the implementation of skilled commissioning for care provision [ 29].
During the inception of the program a strong linkage between community, TBAs, HEWs and health facility was thought to promote implementation of skilled delivery attendance and Emergency Obstetric care (EmOC).
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Effective implementation of that policy presupposes existence of skilled staff involved in selection, planning, procurement, management, maintenance and utilisation of health technologies.
The implementation of a CPAT/AMDA guideline in skilled nursing facilities may reduce falls, verbally aggressive behaviors and antipsychotic usage in residents with dementia.
Future studies should explore the role of supervision and support on effective implementation of the Focused Antenatal Care package in Ngorongoro and the performance of skilled birth attendants.
5, 6 In sub-Saharan Africa, cultural hurdles, financial constraints, and a shortage of skilled practitioners pose tremendous challenges for the implementation of mass circumcision services.
Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of health care providers, and greater family participation in antenatal care visits.
Lack of managerial skills of local health leaders together with limited financial resources, lack of skilled health workers and political interference has been linked to unsuccessful implementation of health programs in developing countries [ 5, 51- 54].
In the 5 years between implementation of the MVP intervention package and subsequent survey, a notable uptake of skilled delivery has been observed.
In Mozambique, health policy directions are formulated in the Plano Estratégico do Sector Saúde (Health Sector Strategic Plan [ 7]), which identifies the deficit of skilled health workers as a major challenge for the implementation of the health policy.
Although implementation of the plan was generally successful, the greatest challenges were limited availability of skilled staff and test reagents.
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