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Table 2 Illustrative quotes for Leadership, Governance and Health Financing

From: Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

Quote 1 Well it [The NSV Program] has never been organised.... it has just never been organised properly. We have tried to make inputs on so many occasions for so many years. But family health services have just never been competently organised themselves.
KII Upper Health System Official
Quote 2 I think the other challenge is awareness, people understanding of the importance of family planning and the issues surrounding the permanent methods of family planning. So those are challenges that we face and specifically on no-scalpel vasectomy. Since 1997 we have had a number of our staff were sent to Indonesia to be trained and now there are only a few you know that are taking the initiative forward. But the rest have gone over and basically because of the difficulties that they face in facilities that are not in a good state for them to perform, or they don’t get the support they need. There are a whole lot of other issues.
KII Upper Health System Official
Quote 3 I mean I am sure that money could be accessed if we really put our minds to it. First of all you need to produce a national program. And then you need to get funding for it. Instead of having UNFPA passing by and saying would you like some funding to do a bit of vasectomy and the answer is always… yes please. And then, then nothing happens. They throw a bit of money at it and they do a bit of something. That is usually fairly ineffectual. Like they run a little vasectomy training program and the people in the program never get to do a vasectomy .... It’s just hopeless.
KII Upper Health System Official
Quote 4 Yeah, about this funding we do normally get this funding from the health department, but we are finding it difficult. For me as a vasectomist, to go out within the district to perform a service to the men and at the same time perform hands on training to the apprentice I need continued funding. Funding is really a problem within this program and within the province.
KII Community Health Worker
Quote 5 Sometimes they tell us that there is no money and we have to wait. Vasectomy, comes under the family health services. The program safe motherhood and so the vasectomy program comes under that safe motherhood family health services. I really don’t know how much we have, but we are just doing the proposal. And it’s up to the people up there, the finance team to approve our patrol [outreach service] and then they give us the funding.
KII Nursing Officer