Service readiness of primary healthcare facilities for dengue management in Bagmati Province, Nepal: a mixed method study.

Background: In Nepal, frequent dengue outbreaks have been reported in the past decades leading abrupt and substantial burden to healthcare system. Thus, this study aimed to assess dengue service readiness and factors influencing readiness at health facilities level.

Methods: A convergent parallel mixed method study was conducted in 131 primary healthcare facilities of the Bagmati Province. Key informant interviews were carried out for exploring facilitators and barriers for dengue service readiness.

Results: The majority of primary healthcare facilities were found with sub-optimal readiness for dengue i.e. 63.4% of facilities and readiness was found varied by health facility type, settings, ecological region, and districts. In the study, health facility type [Primary healthcare centers Adjusted Odds Ratio (AOR): 6.1, CI: 1.5-23.9], review and trend analysis practice [AOR: 3.6, CI: 1.1-11.6], and facilities meetings [AOR: 5.8, CI: 1.2-26.7] were identified as key predictors for service readiness. External supervision, quality assurance practice and stakeholder sensitization were explored as facilitators for the readiness.

Conclusions: Improving and expanding dengue services in all primary healthcare facilities, and ecological regions, having regular facilities meeting, review and trend analysis practice and stakeholder sensitization can enhance dengue service readiness at facility level.