Testing the WHO responsiveness concept in the Iranian mental healthcare system: a qualitative study of service users

Forouzan, Ameneh Setareh; Ghazinour, Mehdi; Dejman, Masoumeh; Rafeiey, Hassan; Sebastián, Miguel San

doi:10.1186/1472-6963-11-325

Cited by 26 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, responsiveness and its tools have been widely used to evaluate the mental intervention service system, HIV testing, and counseling services, among others. Such applications demonstrate that the concept of responsiveness developed by the WHO is also applicable to other special health services [21], [22], [23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Luo

Wang

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

BackgroundWith the objective of the national health services systems reform to move care to the community, community health services (CHS) are becoming the gateways of the health system in China. This study aims to evaluate the levels and distributions of the responsiveness of CHS in urban China and identify the relevant features to provide the government with policy advice on the improvement of CHS responsiveness.MethodsA total of 872 face-to-face interviews were conducted in community health centers (CHCs) from 2007 to 2009. Indicators of responsiveness that were recommended by the World Health Organization were adopted, and non-conditional logistic regression analysis was performed to explore the factors associated with the levels and distributions of the responsiveness of CHS.ResultsThe responsiveness scored at a fairly ‘good’ level of 7.45, 7.45, and 7.46 for CHS in years 2007, 2008, and 2009, respectively. The representative responsiveness inequality indexes were 0.097, 0.101, and 0.109, respectively, indicating the moderately balanced distributions of responsiveness in these three years. During this period, the scores of responsiveness elements were highest at 7.44 to 8.34 in “dignity”, “communication”, and “social support”, while lowest at 6.76 to 7.54 in “autonomy”, “confidentiality”, and “basic amenities”. The results of the logistic regression analysis suggested that five elements (OR value), namely, “dignity” (1.414–3.345), “communication” (1.218–3.655), “basic amenities” (1.251–2.362), “prompt attention” (1.098–1.590), and “autonomy” (1.416–2.173), had significant associations with CHS responsiveness.ConclusionsThe responsiveness of CHS in Wuhan City was fairly good but still requires further improvement, particularly on the working conditions of CHCs and communication skills trainings among CHS workers.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Luo

Wang

et al. 2013

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…In a previous qualitative study, we evaluated the applicability of this concept to mental health care in Iran. With some modifications, the concept was proved to suit Iranian mental health service users’ expectations ( 17 ). A new domain of effective care was added; the domain of prompt attention was divided into two new domains (attention and access to care), and the domains choice of health-care providers and autonomy were combined into one domain (Table 1 ) ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

“…In accordance with the WHO health system responsiveness questionnaire ( 19 ) and the findings of our previous qualitative study ( 17 ), a Farsi version of the mental health system responsiveness questionnaire was adapted to suit the mental health-care system in Iran ( 18 ). Classic psychometric criteria of the Farsi version of the questionnaire have been measured and its feasibility, reliability, and validity tested previously ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran

Forouzan

Padyab

Rafiey

et al. 2016

Front. Public Health

Self Cite

View full text Add to dashboard Cite

As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect.

show abstract

“…The English version Health System Responsiveness Questionnaire was translated into Farsi by the first author. The translated version was adapted based on the findings of our previous qualitative studies in which we evaluated the applicability of the health system responsiveness concept to the Iranian mental health system (15, 16). As a result, a new domain of effective care was added, the domain of prompt attention was divided into two new labeled domains – access to care and attention – moreover, the domains choice of health care providers and autonomy were integrated, and some new questions were added to existing domains.…”

Section: Methodsmentioning

confidence: 99%

Reliability and validity of a Mental Health System Responsiveness Questionnaire in Iran

Forouzan

Rafiey

Padyab

et al. 2014

Global Health Action

Self Cite

View full text Add to dashboard Cite

BackgroundThe Health System Responsiveness Questionnaire is an instrument designed by the World Health Organization (WHO) in 2000 to assess the experience of patients when interacting with the health care system. This investigation aimed to adapt a Mental Health System Responsiveness Questionnaire (MHSRQ) based on the WHO concept and evaluate its validity and reliability to the mental health care system in Iran.DesignIn accordance with the WHO health system responsiveness questionnaire and the findings of a qualitative study, a Farsi version of the MHSRQ was tailored to suit the mental health system in Iran. This version was tested in a cross-sectional study at nine public mental health clinics in Tehran. A sample of 500 mental health services patients was recruited and subsequently completed the questionnaire. Item missing rate was used to check the feasibility while the reliability of the scale was determined by assessing the Cronbach's alpha and item total correlations. The factor structure of the questionnaire was investigated by performing confirmatory factor analysis (CFA).ResultsThe results showed a satisfactory feasibility since the item missing value was lower than 5.2%. With the exception of access domain, reliability of different domains of the questionnaire was within a desirable range. The factor loading showed an acceptable unidimentionality of the scale despite the fact that three items related to access did not perform well. The CFA also indicated good fit indices for the model (CFI=0.99, GFI=0.97, IFI=0.99, AGFI=0.97).ConclusionsIn general, the findings suggest that the Farsi version of the MHSRQ is a feasible, reliable, and valid measure of the mental health system responsiveness in Iran. Changes to the questions related to the access domain should be considered in order to improve the psychometric properties of the measure.

show abstract

Testing the WHO responsiveness concept in the Iranian mental healthcare system: a qualitative study of service users

Cited by 26 publications

References 20 publications

Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran

Reliability and validity of a Mental Health System Responsiveness Questionnaire in Iran

Contact Info

Product

Resources

About