Table 2 The themes, main themes, and subcategories

COVID-19 vaccination

Open or unused COVID-19 vials

The high doses contained in each vaccination vial

Unsuitable COVID-19 vaccination storage conditions

Human error in the vaccination process

The nonuse of COVID-19 vaccines distributed among the centers and the expiry of vaccines

Changes in the need and demand for vaccines

People’s unwillingness to do vaccination

Public mistrust in existing COVID-19 vaccines

Mismanagement of the distribution and redistribution of COVID-19 vaccines

Improper distribution of COVID-19 vaccines in vaccination centers

Failure to redistribute near-expired COVID-19 vaccines

Excess supply and decreased demand for the COVID-19 vaccines

Diverse or ineffective planning for producing COVID-19 vaccines inside the country

Multiplicity and variety of vaccination programs and plans

COVID-19 diagnostic and laboratory kits

Expiration of COVID-19 diagnostic and laboratory kits

A reduction in the number of people referring for COVID-19 screening and diagnostic tests

Excessive provision of COVID-19 diagnostic and laboratory kits without assessing the epidemic conditions

Failure to redistribute near-expired COVID-19 diagnostic kits

Quantitative and qualitative defects in COVID-19 diagnostic kits

Noncompliance with the COVID-19 kits sent from the ministry with the laboratory equipment in medical center

Unavailability of valid COVID-19 diagnostic and laboratory kits in the market

Errors in COVID-19 diagnostic and laboratory tests and the need to repeat the tests

A large number of COVID-19 tests

Conducting routine and induction COVID-19 diagnostic tests

Conducting diagnostic tests to prepare statistics and report the COVID-19 trends

Applying for PCR tests to confirm COVID-19

COVID-19 medicines and medical supplies

Ineffectiveness and expiration of COVID-19 medicines

Frequent changes in drug treatment protocols for COVID-19

Changes in treatment algorithms due to medical advances

Poor drug supply and consumption chain management

Indiscriminate preparation and distribution of medicines without assessing the COVID-19 condition

Not redistributing near-expired COVID-19 drugs

Inaccurate inventory drug and expiry date control

Inaccurate assessment of needs and reasonable consumption

Absence of a regular inventory and consumption recording and tracking system

Human resources

Disorganization and inconsistency in distributing staff in medical centers

Making decisions and formulating instructions based on the function of selected COVID-19 centers

Ineffective planning for staff distribution

Ineffective use of human resources

Low productivity of the staff in selected COVID-19 centers

Nonoptimal use of staff capacities

Lack of adequate experience and skills in medical staff in selected COVID-19 treatment and vaccination centers and reference laboratories

Reduced staff productivity and absenteeism due to COVID-19

The mismatch between staff’s skills and assigned tasks in medical centers

Lack of updated job descriptions and mismatch with the staff’s expectations