Health System Responsiveness for HIV/AIDS Treatment and Care Services in Shewarobit, North Shewa Zone, Ethiopia

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.

Health System Responsiveness and Its Associated Factors Among Outpatients in Primary Health Care Facilities, Asagirt District, NorthShewa Zone, Ethiopia, 2021: Cross Sectional Study Design

“…The possible explanation for this difference might be in the result from the Health Minister was only an average report. Similarly, the result was higher than a study conducted in Shewarobit, Ethiopia (55.3%) [37]. This could be differences in the study participants, in this study we investigated HSR among all outpatients in the District from each primary health care facility in the District, however, in Shewarobit the study was conducted on case-specific responsiveness among HIV positive individuals.…”

“…The eighth domain (access to social support network) was not assessed since it is used for assessing inpatients (hospitalization) only [11,31]. All the 28 items were computed and then it was dichotomized as "acceptable" and "unacceptable" by the demarcation threshold formula as: [37][38][39]. Accordingly, those who scored 73 and above HSR was considered as "Acceptable" and below considered as "Unacceptable".…”

“…Perceived quality of care score: assessed by 12 questions of the clients' perception about the services they offered, professionalism of provider as well as, the patient values and interests in the services. Then it was dichotomized into "high" for those who scored above 37 and "low" for those who scored 37 and less [37].…”

“…) + [37][38][39]. Accordingly, those who scored 73 and above HSR was considered as "Acceptable" and below considered as "Unacceptable".…”

“…Likewise, all the seven domains were added separately and grouped as good and poor by the above formula [37][38][39]. Above the cut-off point to determine "Good" performance, while including cutoff point and below scores were considered as "Poor" for each domain independently.…”