Assessing health system responsiveness in primary health care facilities in Tanzania

Author:

Kapologwe Ntuli A.ORCID,Kibusi Stephen M.,Borghi Josephine,Gwajima Dorothy O.,Kalolo Albino

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

Subject

Health Policy

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.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3