# Facilitators and barriers of general health service readiness in the primary level public health facilities of Baitadi, Nepal: A qualitative study

## TL;DR

This study explores what helps or hinders health service readiness in primary health facilities in Baitadi, Nepal.

## Contribution

The study identifies context-specific facilitators and barriers to health service readiness in a resource-limited setting.

## Key findings

- Low health service readiness was linked to poor infrastructure, drug shortages, and equipment gaps.
- Regular staff meetings, supportive leadership, and coordination were key facilitators of readiness.
- Geographic barriers and supply delays were major systemic obstacles to service readiness.

## Abstract

Health service readiness is crucial for the healthcare facilities to deliver quality care. Ensuring service readiness not only improves the quality of care but also enhances patient trust, service utilization, and overall health system performance, particularly in resource-constrained settings. The aim of this study was to explore the facilitators and barriers of general health service readiness in primary-level health facilities of Baitadi, Nepal. A cross-sectional study was conducted among the ten primary public health facilities of Baitadi, Nepal using a qualitative method. Ten key informant interviews were conducted with health facility in-charges. The inter-coder reliability was found 81.8% and Braun and Clarke’s thematic analysis was carried out for the analysis using RQDA software. Five themes and eleven subthemes were identified from the analysis. Facilities with low health service readiness commonly lacked adequate physical infrastructure, and faced frequent shortages of essential drugs and equipment. Limited trainings and irregular supervision further hindered readiness. Geographical barriers and procurement delays slowed the supply of resources, while regular staff meetings, supportive municipal leadership, and effective coordination emerged as key facilitators. Overall, the study highlights that improving coordination, leadership, and motivation of health service provider is essential for strengthening service readiness in resource-limited settings. Addressing persistent systemic obstacles such as difficult terrain, delays in supplies, and gaps in infrastructure remains equally important. Focusing on these priority areas through evidence-based and context-specific strategies can contribute to more responsive and higher-quality health services.