Health System Responsiveness and Associated Factors Among Outpatients in Primary Healthcare in Boricha District

Abstract

Background: Health system responsiveness is a crucial component for improving public health. While previous studies did not considered factors like; type of patients, physical disability, type of illness, and community-based health insurance membership. This study aimed to assess health system responsiveness and its associated factors among outpatients in primary healthcare settings in Boricha District, Ethiopia.

Methods: An institution-based cross-sectional quantitative study was conducted from April 1 to 30, 2024. Data were collected through structured and pretested questionnaires administered by interviewers. Multivariable binary logistic regression analysis was used to identify factors associated with overall responsiveness. Adjusted odds ratios with their corresponding 95% confidence intervals were used to determine factors associated with responsiveness, with a significance level of p<.05.

Results: The overall responsiveness was 57.7% with confidentiality rated highest. Males were 2.5 times more likely to have good HSR than females, and the odds of acceptable overall responsiveness among outpatients who visited hospital care were 2.5 times higher than those in a health center. Patients with perceived good health status and non-members of community-based health insurance showed higher responsiveness than their counter parts by 5 and 7 folds, respectively. Similarly, patients who were repeated visitor had 3.8 times more likely to have acceptable HSR compared to those who were new visitor. And, patients with chronic illness had 4 times more likely to have acceptable responsiveness than their counter parts. The likelihood of the acceptable overall responsiveness among patients treated by traditional healers was 3 times higher.

Conclusion: The overall responsiveness in primary healthcare facilities in the district was 57.7%. It was affected by gender, the type of health facility, subjective health status, type of patients, type of illness, the use of traditional medicines, and membership in community-based health insurance schemes.