system responsiveness
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2021 ◽  
Vol XXIV (Issue 4B) ◽  
pp. 659-667
Author(s):  
Katarzyna Hampel ◽  
Paulina Ucieklak-Jez ◽  
Agnieszka Bem

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258092
Author(s):  
Ritbano Ahmed Abdo ◽  
Hassen Mosa Halil ◽  
Biruk Assefa Kebede ◽  
Abebe Alemu Anshebo ◽  
Minychil Demelash Ayalew ◽  
...  

Background Health system responsiveness refers to non-financial, non-clinical qualities of care that reflect respect for human dignity and interpersonal aspects of the care process. The non-clinical aspects of the health system are therefore essential to the provision of services to patients. Therefore, the main purpose of this study was to assess the responsiveness in maternity care, domain performance and factors associated with responsiveness in maternity care in the Hadiya Zone public Hospitals in Southern Ethiopia. Methods A hospital-based cross-sectional study was employed on 413 participants using a systematic sampling technique from 1 July to 1 August 2020. An exit interviewer–administered questionnaire was used to collect data. EpiData (version 3.1) and SPSS (version 24) software were used for data entry and analysis, respectively. Bivariate and multivariable logistic regression were computed to identify the associated factors of health system responsiveness in maternity care at 95% CI. Results The findings indicated that 53.0% of users gave high ratings for responsiveness in delivery care. In the multivariable logistic regression analysis, mothers aged ≥ 35 (AOR = 0.4; 95% CI = 0.1–0.9), urban resident (AOR = 2.5; 95% CI = 1.5–4.8), obstetrics complications during the current pregnancy (AOR = 2.1; 95% CI = 1.1–3.0), and caesarean delivery (AOR = 0.4; 95% CI = 0.2–0.7) were factors associated with poor ratings for responsiveness in maternity care. Conclusion In the hospitals under investigation, responsiveness in maternity care was found to be good. The findings of this study suggest that the ministry of health and regional health bureau needs to pay attention to health system responsiveness as an indicator of the quality of maternity care.


2021 ◽  
Author(s):  
Wubshet Debebe Negash ◽  
Chalie Tadie Tsehay ◽  
Lake Yazachew ◽  
Desale Bihonegn Asmamaw ◽  
Dawit Zenamarkos Desta ◽  
...  

Abstract Background: Health system responsiveness is defined as the outcome of designing health facility relationships in such a way that they are familiar and respond appropriately to patients’ universally legitimate expectations. Even though different strategies have been implemented to measure responsiveness, only scanty evidence exists in Sub-Saharan Africa. In Ethiopia information about the level of health system responsiveness among outpatients is scant. Assessing responsiveness could help facilities in improving service delivery based on patient expectations. Objective: The study aimed to assess health system responsiveness and associated factors among outpatients in primary health care facilities, Asagirt District, North Shewa Zone, Ethiopia, 2021. Methods: Facility-based cross-sectional quantitative study was implemented between 30th March and April 30/2021. A systematic random sampling technique was employed to select 423 participants, and interviewer-administered data were collected using a structured and pretested questionnaires. Both bivariable and multivariable logistic regressions were employed to identify factors that have an association with health system responsiveness. Adjusted Odds Ratio with their corresponding 95% CI was used to declare factors associated with health system responsiveness. A p-value less than 0.05 was used to declare statistical significance in this study. Results: The overall health system responsiveness was 66.2% (95% CI: 61.4% - 70.7%). Confidentiality and dignity domains were the highest responsiveness score. Health system responsiveness was higher among satisfied outpatients (AOR: 9.9, 95% CI: 5.11-19.46), utilized private clinics (AOR: 8.8, 95% CI: 4.32-18.25), and no transport cost (AOR: 1.7, 95% CI: 1.03-2.92) in the study setting. Conclusion: Overall health system responsiveness was higher as compared to other case-specific study in Ethiopia. The domains of Autonomy, Waiting time, Basic amenities, and Choice were identified as vital areas needing the effort to raise responsiveness of health care service in the District. HSR was higher in private than public healthcare facilities, among satisfied clients and those who didn’t pay for transport on their way to the health facility than their counterparts. Thus, enhancing patient satisfaction, using input from service users, Collaboration, and experience exchange between public and private facilities will be important interventions to improve HSR.


Author(s):  
Tammy Sutherns ◽  
Jill Olivier

Background: Despite governments striving for responsive health systems and the implementation of mechanisms to foster better citizen feedback and strengthen accountability and stewardship, these mechanisms do not always function in effective, equitable, or efficient ways. There is also limited evidence that maps the diverse array of responsiveness mechanisms coherently across a particular health system, especially in low- and middle-income country (LMIC) contexts. Methods: This scoping review presents a cross-sectional ‘map’ of types of health system responsiveness mechanisms; the regulatory environment; and evidence available about these; and assesses what is known about their functionality in a particular local South African health system; the Western Cape (WC) province. Multiple forms of indexed and grey literature were synthesized to provide a contextualized understanding of current ‘formal’ responsiveness mechanisms mandated in national and provincial policies and guidelines (n = 379). Various forms of secondary analysis were applied across quantitative and qualitative data, including thematic and time-series analyses. An expert checking process was conducted, with three local field experts, as a final step to check the veracity of the analytics and conclusions made. Results: National, provincial and district policies make provision for health system responsiveness, including varied mechanisms intended to foster public feedback. However, while some are shown to be functioning and effective, there are major barriers faced by all, such as resource and capacity constraints, and a lack of clarity about roles and responsibilities. Most mechanisms exist in isolation, failing to feed into an overarching strategy for improved responsiveness. Conclusion: The lack of synergy between mechanisms or analysis of varied forms of feedback is a missed opportunity. Decision-makers are unable to see trends or gaps in the flow of feedback, check whether all voices are heard or fully understand whether/how systemic response occurs. Urgent health system work lies in the research of macro ‘whole’ systems responsiveness (levels, development, trends).


2021 ◽  
Vol 19 (2) ◽  
Author(s):  
Piotr Nawrocki ◽  
Patryk Osypanka

AbstractPredicting demand for computing resources in any system is a vital task since it allows the optimized management of resources. To some degree, cloud computing reduces the urgency of accurate prediction as resources can be scaled on demand, which may, however, result in excessive costs. Numerous methods of optimizing cloud computing resources have been proposed, but such optimization commonly degrades system responsiveness which results in quality of service deterioration. This paper presents a novel approach, using anomaly detection and machine learning to achieve cost-optimized and QoS-constrained cloud resource configuration. The utilization of these techniques enables our solution to adapt to different system characteristics and different QoS constraints. Our solution was evaluated using a system located in Microsoft’s Azure cloud environment, and its efficiency in other providers’ computing clouds was estimated as well. Experiment results demonstrate a cost reduction ranging from 51% to 85% (for PaaS/IaaS) over the tested period.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Gadija Khan ◽  
Nancy Kagwanja ◽  
Eleanor Whyle ◽  
Lucy Gilson ◽  
Sassy Molyneux ◽  
...  

Abstract Background The World Health Organisation framed responsiveness, fair financing and equity as intrinsic goals of health systems. However, of the three, responsiveness received significantly less attention. Responsiveness is essential to strengthen systems’ functioning; provide equitable and accountable services; and to protect the rights of citizens. There is an urgency to make systems more responsive, but our understanding of responsiveness is limited. We therefore sought to map existing evidence on health system responsiveness. Methods A mixed method systemized evidence mapping review was conducted. We searched PubMed, EbscoHost, and Google Scholar. Published and grey literature; conceptual and empirical publications; published between 2000 and 2020 and English language texts were included. We screened titles and abstracts of 1119 publications and 870 full texts. Results Six hundred twenty-one publications were included in the review. Evidence mapping shows substantially more publications between 2011 and 2020 (n = 462/621) than earlier periods. Most of the publications were from Europe (n = 139), with more publications relating to High Income Countries (n = 241) than Low-to-Middle Income Countries (n = 217). Most were empirical studies (n = 424/621) utilized quantitative methodologies (n = 232), while qualitative (n = 127) and mixed methods (n = 63) were more rare. Thematic analysis revealed eight primary conceptualizations of ‘health system responsiveness’, which can be fitted into three dominant categorizations: 1) unidirectional user-service interface; 2) responsiveness as feedback loops between users and the health system; and 3) responsiveness as accountability between public and the system. Conclusions This evidence map shows a substantial body of available literature on health system responsiveness, but also reveals evidential gaps requiring further development, including: a clear definition and body of theory of responsiveness; the implementation and effectiveness of feedback loops; the systems responses to this feedback; context-specific mechanism-implementation experiences, particularly, of LMIC and fragile-and conflict affected states; and responsiveness as it relates to health equity, minority and vulnerable populations. Theoretical development is required, we suggest separating ideas of services and systems responsiveness, applying a stronger systems lens in future work. Further agenda-setting and resourcing of bridging work on health system responsiveness is suggested.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045621
Author(s):  
John Whitaker ◽  
Guy Harling ◽  
Ali Sie ◽  
Mamadou Bountogo ◽  
Lisa R Hirschhorn ◽  
...  

ObjectivesThis study aimed to evaluate the epidemiology of injury as well as patient-reported health system responsiveness following injury and how this compares with non-injured patient experience, in older individuals in rural Burkina Faso.DesignCross-sectional household survey. Secondary analysis of the CRSN Heidelberg Ageing Study dataset.SettingRural Burkina Faso.Participants3028 adults, over 40, from multiple ethnic groups, were randomly sampled from the 2015 Nouna Health and Demographic Surveillance Site census.Primary and secondary outcome measuresPrimary outcome was incidence of injury. Secondary outcomes were incidence of injury related disability and patient-reported health system responsiveness following injury.Results7.7% (232/3028) of the population reported injury in the preceding 12 months. In multivariable analyses, younger age, male sex, highest wealth quintile, an abnormal Generalised Anxiety Disorder score and lower Quality of Life score were all associated with injury. The most common mechanism of injury was being struck or hit by an object, 32.8%. In multivariable analysis, only education was significantly negatively associated with odds of disability (OR 0.407, 95% CI 0.17 to 0.997). Across all survey participants, 3.9% (119/3028) reported their most recent care seeking episode was following injury, rather than for another condition. Positive experience and satisfaction with care were reported following injury, with shorter median wait times (10 vs 20 min, p=0.002) and longer consultation times (20 vs 15 min, p=0.002) than care for another reason. Injured patients were also asked to return to health facilities more often than those seeking care for another reason, 81.4% (95% CI 73.1% to 87.9%) vs 54.8% (95% CI 49.9% to 53.6%).ConclusionsInjury is an important disease burden in this older adult rural low-income and middle-income country population. Further research could inform preventative strategies, including safer rural farming methods, explore the association between adverse mental health and injury, and strengthen health system readiness to provide quality care.


2021 ◽  
Vol Volume 15 ◽  
pp. 581-588
Author(s):  
Getachew Asefa ◽  
Asmamaw Atnafu ◽  
Endalkachew Dellie ◽  
Tsegaye Gebremedhin ◽  
Andualem Yalew Aschalew ◽  
...  

2021 ◽  
Author(s):  
Leila Doshmangir ◽  
Ahmad Ahmadi Teymourlouy ◽  
Parinaz Doshmangir ◽  
Rahim Khodayari-Zarnaq ◽  
Vladimir Gordeev

Abstract Introduction: Globally, the number and proportion of people aged 60 years and older is growing fast. As people age, health needs become more complex, and the health system responsiveness to older people's needs requires evidence-informed policies. This study explored the factors affecting the process of health policies development for older people in Iran. Methods: We reviewed and analysed policy documents related to health policies development for older people in Iran. We also conducted 32 interviewers with people aged 60 years and older and 21 interviews with key informants involved in policy-making related to older people. Qualitative data were analysed using thematic analysis.Findings: Actors and stakeholders, policy structure and selected health policy processes, the system of health care service delivery, government financial support, community and culture building are prominent factors that influence health policy-making for older people. Conclusion: To identify and implement effective policy options for older people, the Iranian health system needs to change its health policy-making approach for this target group. It requires a revision of existing structures and processes, timely planning and provision of a comprehensive range of quality services tailored to specific needs of older people, strengthening intersectoral cooperation and coordination to enable evidence-informed policies, facilitation and maintenance of health system responsiveness.


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