A community based cross-sectional study on the health system responsiveness in the urban field practicing area of tertiary health care centre, Hyderabad

Jyothi Lakshmi Naga Vemuri, B. Kiranmai, Viveka Cheedarla, S. Bhavana Laxmi


Background: According to WHO, responsiveness is an important goal of the health system, in addition to the two predominant goals of improving health and fairness of financing. Responsiveness includes non-medical aspects of health care. As the progress to universal health coverage is gaining pace, the present study has attempted to study the domains of responsiveness in the government and private health services and health care providers.

Methods: A community based cross-sectional study for a period of 3 months in the households of the urban field practising area. Sampling technique was simple random sampling. Assuming the prevalence of 50% and allowable error of 5%, 400 households were surveyed. KISH table method was used at household level. Study tool was World Health Survey responsiveness module questionnaire for the eight responsiveness domains-prompt attention, dignity, communication, autonomy, confidentiality, choice, quality of basic facilities and social support (for inpatients).

Results: The mean age (yrs) of the study subjects is 46.078±13.998. 68.25% (273) were males.31.75% (127) were females. 46.25% (185) were using government services and 53.75% (215) were using private services. The mean waiting time (min) in the public health facilities was 135.2±111.2 which was more than private facilities, 62.4±40.8.

Conclusions: All the responsiveness domains (except confidentiality) were found to be positively associated (p<0.05) with the government health services. Proportion of people rating the responsiveness domains from most important to the least important showed prompt attention (52%) and dignity (30%) as the most important domains.


Health system, Responsiveness, Community based study, Public health services, Private health sector

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De Silva A. A Framework for Measuring Responsiveness (Discussion Paper 32) (2000). Available at: .pdf. Accessed on 13 November 2017.

Rashidian A, Kavosi Z, Majdzadeh R, Pourreza A, Pourmalek F, Arab M, et al. Assessing health system responsiveness: a household survey in 17th district of Tehran. Iranian Red Crescent Med J. 2011;13(5):302-8

Ebrahimipour H, Vafaei Najjar A, Khani Jahani A, Pourtaleb A, Javadi M, Rezazadeh A, et al. Health system responsiveness. A Case Study of General Hospitals in Iran. Int J Health Policy Management. 2013;1(1):85-90.

WHO Multi-country survey study of Health and Health system Responsiveness (2001)-sample report. Available at: responsiveness/papers/MCSS_Analytical_Guidelines.pdf. Accessed on 15 November 2017.

Malhotra C, Do YK. Socio-economic disparities in health system responsiveness in India. Health Policy Planning. 2012;28(2):197-205.

Luo Q, Wang Q, Lu Z, Liu J, Reza H. Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City. PLoS ONE. 2013;8(5):e62923.

Murante AM, Seghieri C, Vainieri M, Schäfer WLA. Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors. Soc Sci Med. 2017;186:139-47.

Bazzaz MM, Taghvaee MR, Salehi M, Bakhtiari M, Shaye ZA. Health System's Responsiveness of Inpatients: Hospitals of Iran. Global J Health Sci. 2015;7(7):106-13.