Abstract:
Abstract
Background: Health system responsiveness is defined as how well the health
system meets the legitimate expectations of the population regarding the non-health
enhancing aspects of the care process. Information on responsiveness helps health
policymakers and facilities to improve delivery care service in the health system.
However, there is limited information regarding to non-clinical aspects of delivery care
in our country.
Objective: To assess health system responsiveness and associated factors for
delivery care in public health facilities, Dessie city administration, Northeast Ethiopia,
2022.
Methods: Institutional based cross-sectional study was conducted from June 1 to July
5, 2022, at public health facilities in Dessie city administration. A total 454 mothers
were selected through systematic random sampling technique and response rate was
94.7%. The data were collected by pretested structured interview administered
questionnaire, reviewing delivery registration books and client charts. Nine data
collectoers and two supervisors were employed. The data were entered to Epi data
version 4.6 software and exported to Stata version 14 statistical software for analysis.
Bivariable and multivariable binary logistic regression analysis were employed to
check the association of variables with HSR. AOR with 95% CI was determined to see
the strength of association, and P<0.05 was taken as level of statistical significance.
Model fitness was checked by Hosmer and Lemeshow test (p=0.84).
Results: In this study, the overall health system responsiveness was 45.8% (95% CI:
41.1-50.6). Dignity was the highest performance domain (74.2%) while basic amenity
was the least (45.8%). In multivariable regression analysis, caesarian delivery (AOR:
3.67, 95%CI [1.91–7.06]), birth within 5:30 PM to 8:30 AM (AOR: 0.51, 95%CI [0.320.81),
referred
during
labor
(AOR:
0.36,
95%CI
[0.18-0.69]),
obstetric
complication
in
current
pregnancy
(AOR:
0.45,
95%CI
[0.23-0.85])
and
good
satisfaction
(AOR:
5.77,
95%CI
[3.44-9.69])
were
statically
significant
associated
factors
with
HSR.
Conclusion and recommendations: the overall responsiveness performance in
delivery care was relatively lower than previous studies in Ethiopia. For better
improvement of HSR in delivery care, health professionals have to prevent obstetric
complications, give emphasis to mothers during spontaneous vaginal delivery like
caesarean delivery, improve mothers’ satisfaction and receive necessary information
during referral handover. Furthermore, health facilities need to improve qualities of
basic amenities for better responsiveness performance in delivery care.
Keywords: Health system responsiveness, Delivery care, factors, Dessie, Ethiopia.
