Abstract:
Dengue remains one of the most important mosquito borne diseases in Sri Lanka, causing
recurrent outbreaks despite the availability of national prevention policies. This indicates a
persistent gap between policy formulation and field level implementation. Such gaps are not
only technical public health concerns but also raise ethical, equity, and social implications, as
vulnerable communities may experience a disproportionate disease burden when prevention
systems are weak. This mixed method study assessed the knowledge, attitudes, and practices
of health officials involved in dengue prevention in Sri Lanka and explored system level barriers
affecting implementation. A descriptive cross sectional design was used. Quantitative data were
collected from 80 health officials representing Medical Officers, Public Health Inspectors/Public
Health Officials, Field Workers, and Administrative Staff using a WHO adapted, translated, and
pre tested questionnaire. Qualitative data were obtained through 10 key informant interviews.
Quantitative data were analysed using descriptive statistics, ANOVA, and Chi square tests,
while qualitative data were analysed thematically. Only 27.5% of participants had satisfactory
knowledge of dengue prevention policy and national targets. Although attitudes were moderately
positive, reported prevention practices were weak, with only 11.3% demonstrating good practices.
Knowledge and practice scores differed significantly across professional groups, indicating unequal
training and capacity within the workforce. Qualitative findings identified barriers such as staff
and resource shortages, funding delays, weak intersectoral coordination, limited enforcement
authority, training gaps, and underuse of surveillance tools. The findings highlight the need to
strengthen workforce capacity, governance support, intersectoral coordination, and field level
implementation. Improving dengue prevention is essential not only to reduce disease burden but
also to promote fairness, public trust, and social well being.
