Determinant of malaria service readiness at health facility: Evidence from 2018 Service Availability and Readiness Assessment: Cross sectional study

Abstract Background: Globally, an estimated 3.3 billion people are at the risk of malaria. The majority of cases have occurred in the African Region. This study aims to assess the determinant of malaria service readiness at the health facility level.Method: Data from the 2018 Service Availability and Readiness Assessment was used for this analysis. The study was a facility-based cross-sectional study and a stratified sampling technique was used. Data was collected from October - December 2017. Mean readiness score was used by computing six tracer items (Available of at least one trained staff for malaria diagnosis & treatment, Available malaria diagnosis & treatment guideline, Malaria diagnostic capacity, First-line anti-malarial drug in-stock, Paracetamol cap/tab, and ITN). Linear regression was used to identify factors associated with the mean readiness score of health facility to provide malaria service. The proportion test was used to check any change between 2016 and 2018 malaria service readiness.Result: A total of 764 facilities were included in the study, of these only 682(89.3%) of facilities were provide malaria service. Eighty-nine percent of facilities offer diagnosis or treatment of malaria service and 70% of the facility diagnosis malaria by clinical symptom followed by microscopy (67%) and Rapid Diagnostic Tests (RDT) (46%). Only 3%facilities had all the six tracer items. Hospitals and health centers had the availability of tracer items above the average mean readiness score (52%). Facilities managed by other than public authorities were had lower mean score readiness for malaria service compared with those managed by the public. Higher & medium clinics, health posts, and Lower clinics were had lower mean score readiness for malaria service compared with hospitals. A significant change was not observed for malaria service readiness of tracer items between 2016 and 2018 (p-value=0.732).Conclusion: The study revealed that higher & medium clinics, lower clinics, health posts, facilities managed by other authorities and region were the determinate factor of malaria service readiness.Keyword: Malaria, Service availability, and readiness