Abstract:
Abstract
Background: Health system responsiveness (HSR) measures the non-medical and nonfinancial
aspect
of
care
relating
to
the
environment
and
the
way
healthcare
is
provided
to
clients.
It
refers
to
clients
universally
legitimate
expectations.
The
health
care
system
is
expected
to
respond
the
needs,
expectation
of
people
infected
with
HIV
(PIWH), which
helps to adhere well to treatments and have better health outcome.
Objective: The aim of the study was to assess the Health system responsiveness of
HIV/AIDS treatment and care services and associated factors among public health
facilities in Shewa Robit Town, North Shewa Zone, Northcentral Ethiopia, 2020.
Methods: An institutional-based cross-sectional study design with a mix of quantitative
and qualitative data collection methods was used to assess the HSR of HATCS in public
health facilities of Shewa Robit town. A randomly selected 445 ART users and five health
workers purposefully were used for the exit interview and key informant interview
respectively. Responsiveness was measured using seven domains. The quantitative data
was entered to Epi-data version 4.6 software and exported to SPSS version 20 software
for analysis. Linear regression model was fitted after all the assumptions were checked.
All Variables having a p value of less than 0.2 during bi-variable analysis were entered to
multi-variable analysis. In the final multivariable linear regression analysis, ?-coefficient
with 95% confidence interval (CI) was used to declare the factors associated with the
performance of HSR. The qualitative data was analyzed using a thematic analysis.
Results: The mean total responsiveness score was 90.01(88.1-91.6) with its RPS of
78.26% (76.61-79.66). “Fail” responsiveness performance was higher for choice (65.2%),
autonomy (32.4%), and prompt attention (15.3%) domains. Being treated in health center
3.1(0.45-5.75), satisfaction with the services 1.49(1.13-1.8) and the perceived quality of
care 0.41(0.24-0.57) were positively associated with the RPS whereas perceived good
health status -3.33(-5.86-(-0.8)) and long traveling time to reach the facility -13.71(-16.81(-10.07))
were
negatively
associated.
Conclusion
and recommendations: The overall responsiveness was very good
(78.26%). Improving the quality of service, satisfaction of clients and other factors of HSR
by health providers might improve the “fail” categories of responsiveness performance.
Keywords: Responsiveness, HIV/AIDS, treatment and care services, Ethiopia
