Health System Responsiveness and Associated Factors for Delivery care in Public Health Facilities, Dessie City Administration, Northeast Ethiopia, 2022.

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.