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Table 6 Summary of key findings under delivery arrangement level of health system

From: Barriers and facilitators to implementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review

Systems-level factors: Delivery arrangement

Number and type of studies a

Reported as barriers

Reported as facilitators

Related to b

Implementation

Uptake

Sustainability

Human resource planning and management

 Human resource planning

N = 5

Qualitative (2); Mixed (2); Case studies (1)

N = 4

[46, 52, 63, 79]

N = 2

[52, 77]

X

X

X

 Human resource management

N = 7

Qualitative (3); Cross-sectional (1); Mixed (2); Case studies (1)

N = 5

[45, 46, 52, 74, 78]

N = 2

[48, 62]

X

X

 

Health facility-related factor

 Facility environment

N = 6

Qualitative (3); Cross-sectional (1); Mixed (2)

N = 4

[52, 54, 56, 74]

N = 2

[63, 77]

 

X

X

 Supplies and materials

N = 11

Qualitative (4); Cross-sectional (2); Mixed (5)

N = 11

[42, 45, 46, 52, 54, 56, 62, 63, 74, 75, 78]

–

X

X

 

 Patient waiting time

N = 3

Qualitative (1); Mixed (2)

N = 3

[45, 52, 56]

–

 

X

X

 Interpersonal skills

N = 7

Qualitative (3); Cross-sectional (2); Mixed (2)

N = 7

[45, 46, 52, 56, 61, 65, 74]

–

 

X

X

Accessibility of health facility

 Distance to facility

N = 17

Qualitative (9); Cross-sectional (2); Mixed (4); Case studies (2)

N = 11

[4, 31, 33, 38, 45, 46, 52, 53, 57, 77, 79]

N = 7

[32, 33, 35, 52, 58, 65, 66]

 

X

 

 Choice of facility

N = 3

Qualitative (3)

N = 2

[46, 76]

N = 1

[57]

 

X

X

 Referral systems

N = 5

Qualitative (1); Cross-sectional (2); Case studies (2)

N = 3

[31, 36, 46]

N = 2

[48, 59]

 

X

X

Marketing and promotion strategies

 Adequacy of campaigns

N = 11

Qualitative (2); Cross-sectional (5); Mixed (3); Case study (1)

N = 8

[41, 43, 44, 54, 56, 58, 75, 77]

N = 3

[48, 57, 62]

X

X

X

 Marketing technique

N = 4

Qualitative (1); Cross-sectional (1); Mixed (1); case study (1)

N = 2

[57, 79]

N = 2

[33, 43]

 

X

 
  1. a Some of the studies included both barriers and facilitators
  2. b X symbol denotes whether the factor relates to implementation, uptake or sustainability