Health system responsiveness of HIV/AIDS treatment and care services in Shewarobit town public health facilities, North Shewa Zone, Ethiopia, 2020.

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