Abstract:
Purpose: Health System Responsiveness is the key objective of the health system used to
fulfil patients’ universal legitimate expectations. However, the health system’s responsiveness to HIV/AIDS was not assessed in Ethiopia. Therefore, this study aimed at assessing the
health system responsiveness of HIV/AIDS treatment and care services and associated
factors in the public health facilities of Shewarobit town, Ethiopia.
Patients and Methods: An institution-based cross-sectional study was employed from 15
February to 15 April 2020 in the public health facilities of Shewarobit town. The data were
collected among 416 randomly selected Anti-Retroviral Therapy (ART) users using an
interviewer-administered questionnaire. Responsiveness was measured using 27 Likert
scale questions across seven responsiveness domains. A binary logistic regression model
was fitted. A p-value of less than 0.05 and AOR with a 95% confidence interval (CI) was
used to declare the associated factors in the final multivariable logistic regression analysis.
Results: The overall health system responsiveness was 55.3% (95% CI: 50.6–59.8). High
performance of responsiveness was found on confidentiality, respect, and communication
domains, whereas poor responsiveness was achieved in prompt attention and choice domains.
Participants aged 50+ years (AOR:2.48, 95% CI, 1.12–5.54), perceived good health (AOR: 3.10,
95% CI: 1.75–5.48), patients’ satisfaction with care (AOR: 2.98, 95% CI: 1.35–6.54) and history
of visiting traditional healers (AOR: 2.50, 95% CI:1.51–4.17) were factors associated with health
system responsiveness of HIV/AIDS treatment and care services in the study area.
Conclusions: Unacceptable responsive performance was found in choice and prompt
attention domains. Participants’ age, perceived health status, history of visiting traditional
healers, and patient satisfaction were factors that affect responsiveness in the study area.
Thus, providing training, frequent supportive supervision, improving community awareness,
and incorporating traditional healers in the modern health system would enhance the health
system responsiveness in Ethiopia.
