Factors associated with provision of healthcare services in slums from service provider’s (supply side) perspective
| Cognitive and experiential factors | |
| Perception/knowledge/experience/preference of health services | Fear of side effects, size of tablet and misconceptions regarding treatment, high demand for drugs in the final year of treatment134 |
| Socioeconomic factors | |
| Income and wealth | Difficulty in directly observing deworming treatment at mealtime due to food shortage134 |
| Social support | Effective community mobilisation134; poor community support135; non-involvement of community members and urban local bodies139; absence of community members during the drug administration exercise134; demand for incentives by community members to take deworming drugs134 |
| Physical environment | |
| Environment of residence area | Environment (sanitation, territory)136; unsanitary environmental conditions134; inaccessibility (filthy and bush environment)134 |
| Cultural and religious factors | |
| Religion | Religious beliefs and mistrust of interventions134 |
| Sociocultural influence | Lack of shared understanding of the problems in community73; unrelated death and the associated negative publicity (of a deworming programme) by the media134 |
| Legal, political and policy factors | |
| Policy issues | Devolution of service delivery transferring funds and responsibilities to elected local bodies137; management by professional managerial and technical cadres137; tight organisation of public health services137; professional support from the state directorate of public health137; healthcare policies132; policy prioritising low social development areas138 |
| Legal issues | Fear of requirement for formal registration136 |
| Health system factors | |
| Cost | Pay scale of frontline healthcare workers135; medicine price140 |
| Quality and safety of services | Knowledge of intervention area by community health workers134 |
| Service organisation and delivery arrangement | Issues related to assignment of tasks136; requirement to follow standardised protocol136; demands from the management136; work overload132 136; underperformance of staff128; documentation work/work burden/no incentive for work135; insufficient time134; attitude of healthcare providers73; lack of supportive staff135; community health worker familiarity with households led to warm reception134; opportunity to integrate mass drug administration with other health interventions134; presence of community health workers and their supervisory structure, and points of referral for serious side effects134; restriction of range of services139; unserved areas and left-out urban slum pockets139; poor monitoring and supervision139; unreliable immunisation and household data128 |
| Facility and resources | Community-based care132; inefficient utilisation of funds128; affordability and availability of medicine140; limited medical supplies73 135; infrastructural facilities135; inadequate space and equipment136; suboptimal training of staff139; insufficient availability of space, logistics and health manpower139 |