Process Evaluation of Health System Responsiveness Level and Associated Factors Among Mothers Gave Birth at Obstetric Ward in a Tertiary Hospital, Southwest of Ethiopia: Mixed Study Methods

Abstract

Gezu Girma,1 Aklilu Tamire,2 Gebeyehu Jeldu Edessa,3 Mesay Dechasa,4 Obsan Kassa Tefasa,2 Abraham Negash,5 Jerman Dereje,6 Awoke Masrie,2 Samrawit Shawel,2 Miheret Mandefro,2 Gelila Abraham3 1Department of Health Research, International Center for AIDS Care and Treatment Program (ICAP), Finfine, Ethiopia; 2School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Harari, Ethiopia; 3Department of Health Policy and Management, Public Health Faculty, Institute of Health Jimma University, Jimma, Oromia, Ethiopia; 4Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia; 5School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 6Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Aklilu Tamire, School of Public Health, College of Health and Medical Science, Haramaya University, P.O. Box 235, Harar, Harari, 3200, Ethiopia, Tel [phone], Email [email protected]: The term responsiveness emerged during the World Health Organization (WHO) report in 2000 as new and essential goals of the health systems to meet the needs of people to their expectations from different services being given in healthcare systems. Obstetric violence and childbirth mistreatment are global problems, but the worst obstetric violence usually occurs in underdeveloped countries. Thus, the main objective of this study was to evaluate the responsiveness of obstetric service at Jimma University Medical Center.Methods: A single-case study design with quantitative and qualitative data collection was employed. Availability with 17 indicators and health system responsiveness with 24 indicators were used. Consecutive sampling technique was used to select the clients and qualitative data were collected from key informants. SPSS version 25 was used for the analysis of quantitative data, whereas thematic analysis was conducted for qualitative data. A multiple linear regression model was fitted after all assumptions were checked and fit to ensure the relation of the dependent variable with independent variables.Results: The overall evaluation was 75.6% and judged good. The resource availability and health system responsiveness were 85.5% and 69.7%, which were judged very good and fair, respectively. A stethoscope and thermometer were not available, while 40% glucose, dexamethasone, and intravenous fluid were the most frequently stocked-out supplies. Dignity (72.1%), confidentiality (71.4%), and prompt attention (70%) were the top three good scores for the health system’s responsiveness. Health system responsiveness significantly associated with the following: Not attending formal education, attending college and above, place of delivery (health center), mode of delivery (cesarean section), and being merchant.Conclusion & Recommendation: The health system responsiveness of delivery service in study setting was good. All stakeholders should work for improving the health system’s responsiveness in delivery service.Keywords: obstetric, health system responsiveness, Jimma University Medical Center, Ethiopia

Keywords

• obstetric
• health system responsiveness
• jimma university medical center
• ethiopia