Patient Preference and Adherence (Mar 2021)
Health System Responsiveness for HIV/AIDS Treatment and Care Services in Shewarobit, North Shewa Zone, Ethiopia
Abstract
Getachew Asefa,1 Asmamaw Atnafu,2 Endalkachew Dellie,2 Tsegaye Gebremedhin,2 Andualem Yalew Aschalew,2 Chalie Tadie Tsehay2 1Shewarobit Primary Hospital, Shewarobit, North Shewa Zone Administration, Amhara National Regional State, Ethiopia; 2Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Chalie Tadie TsehayUniversity of Gondar, P.O. Box: 196, Gondar, EthiopiaEmail [email protected]: Health System Responsiveness is the key objective of the health system used to fulfil patients’ universal legitimate expectations. However, the health system’s responsiveness to HIV/AIDS was not assessed in Ethiopia. Therefore, this study aimed at assessing the health system responsiveness of HIV/AIDS treatment and care services and associated factors in the public health facilities of Shewarobit town, Ethiopia.Patients and Methods: An institution-based cross-sectional study was employed from 15 February to 15 April 2020 in the public health facilities of Shewarobit town. The data were collected among 416 randomly selected Anti-Retroviral Therapy (ART) users using an interviewer-administered questionnaire. Responsiveness was measured using 27 Likert scale questions across seven responsiveness domains. A binary logistic regression model was fitted. A p-value of less than 0.05 and AOR with a 95% confidence interval (CI) was used to declare the associated factors in the final multivariable logistic regression analysis.Results: The overall health system responsiveness was 55.3% (95% CI: 50.6– 59.8). High performance of responsiveness was found on confidentiality, respect, and communication domains, whereas poor responsiveness was achieved in prompt attention and choice domains. Participants aged 50+ years (AOR:2.48, 95% CI, 1.12– 5.54), perceived good health (AOR: 3.10, 95% CI: 1.75– 5.48), patients’ satisfaction with care (AOR: 2.98, 95% CI: 1.35– 6.54) and history of visiting traditional healers (AOR: 2.50, 95% CI:1.51– 4.17) were factors associated with health system responsiveness of HIV/AIDS treatment and care services in the study area.Conclusions: Unacceptable responsive performance was found in choice and prompt attention domains. Participants’ age, perceived health status, history of visiting traditional healers, and patient satisfaction were factors that affect responsiveness in the study area. Thus, providing training, frequent supportive supervision, improving community awareness, and incorporating traditional healers in the modern health system would enhance the health system responsiveness in Ethiopia.Keywords: responsiveness, HIV/AIDS, health systems, Ethiopia
