Abstract
Abstract
Background
Health system performance is one of the important components of the health care delivery; its achievement depends on the quality of services rendered and the health system responsiveness of its beneficiaries. Health system responsiveness is a multi-dimensional concept and is usually measured through several domains. Health system responsiveness (HSR) remains to be a key indicator for evaluation of health system performance in any settings. This study aimed at assessing the situation of health system responsiveness in primary health facilities in Tanzania prior to introduction of the Direct Health Facility Financing (DHFF) program.
Methods
This was a cross sectional study conducted between January and February in 2018. We collected data from 42 primary health facilities (14 health centers and 28 dispensaries) where a questionnaire was administered to a total of 422 participants. The questionnaire collected information on attention, respect to dignity, clear communication, autonomy, access to care, respect to confidentiality and basic amenities. Descriptive analysis was done to determine the distribution of the variables whereas ANOVA and linear regression analysis was employed to discern the association between variables.
Results
More than 67% of participants had visited the same health facility more than 5 times. Sixty seven percent of the patients were residing within 5kms from the public primary health care facilities. The geographical access to health care scored the lowest (43.5% for Dispensaries and 36% for Health center) mean as compared to other domains of health system responsiveness. The highest score was in respect to confidentiality (86.7%) followed by respect to dignity (81.4%). Linear regression analysis revealed no statistical association between any of the social demographic features with the overall HSR performances. However, in post hoc analysis, Pwani and Shinyanga regions didn’t differ significantly in terms of their performances whereas those two regions differ from all other regions.
Conclusion
Based on the study findings health system responsiveness domains has performed relatively poor in many regions except for respect of dignity and confidentiality scored high of all the domains. Shinyanga and Pwani regions scored relatively well in all domains this could have been due to the effect of Results Based financing (RBF) in the respective regions. All in all the Government and other stakeholders in the health sector they should deliberately invest on the access to care domain as seem to be a challenge as compared to others.
Funder
Swiss Development Cooperation
Publisher
Springer Science and Business Media LLC
Reference30 articles.
1. World Health Organization (2000): Measuring health system Responsoveness. World Health Report 2000. Geneva, It can be accessed at http://www.who.int/responsiveness/papers/paper23.pdf. It was accessed on 9th Oct, 2018.
2. Murray CJ, Frenk J. A framework for assessing the performance of health systems. Bull World Health Org. 2000;78(6):717–31. https://doi.org/10.1590/S0042-96862000000600004 It was accessed on 20tb Apr, 2017.
3. Ristea, Ana-Lucia and Stegroiu, Ion and Ioan-Franc, Valeriu and Dinu, Vasile, Responsiveness of Health Systems: A Barometer of the Quality of Health Services (June 9, 2009). Amfiteatru Economic, Vol XI (Issue: 26), pp. 277–287, 2009. Available at SSRN: https://ssrn.com/abstract=2305220. It was accessed on 10 June, 2018.
4. Robone S, Rice N, Smith PC. Health systems responsiveness and its characteristics: a cross-country comparative analysis. Health Serv Res. 2011;46(6 Pt 2):2079–100.
5. Ebrahimipour H, Vafaei Najjar A, Khani Jahani A, Pourtaleb A, Javadi M, Rezazadeh A, Vejdani M, Shirdel A. Health System Responsiveness: A Case Study of General Hospitals in Iran. Int J Health Policy Manag. 2013;1(1):85–90 Accessed on 15th August 2017.
Cited by
35 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献