Responsiveness of services rendered at primary healthcare facilities of Bharatpur, Nepal: a cross-sectional study

Abstract

Introduction Responsiveness of services refers to the way healthcare systems and providers interact with patients and how well they meet patients’ non-clinical expectations and needs. The responsiveness is a crucial aspect of a well-functioning health system while primary healthcare is considered as its foundational cornerstone. However, in low and middle-income countries, there are numerous obstacles to its efficient operation and a very limited understanding of the concept of service responsiveness. This study aimed to assess the responsiveness of services and identify associated factors at primary healthcare facilities of Bharatpur, Nepal.Methods A facility-based cross-sectional study was carried out among 358 patients visiting outpatient department (OPD) of primary healthcare facilities of Bharatpur. A pretested structured interview schedule was used to conduct a face-to-face interview to obtain the information per the study’s objective. Univariate as well as bivariable and multivariable logistic regressions were carried out to obtain the result per our objectives.Results The overall performance of the responsiveness of services was 74.6% (95% CI 70.1 to 78.8), dignity being the highest performing domain (97.2%) and choice being the lowest (22.6%). Respondents aged more than or equal to 50 (adjusted OR (AOR)=4.107, 95% CI 1.28 to 13.14), those who are satisfied with the service (AOR=7.02, 95% CI 3.21 to 15.36), those who perceive high quality of care (AOR=5.69, 95% CI 2.54 to 12.73) and those who did not have to pay for transportation (AOR=4.63, 95% CI 2.20 to 9.72) showed higher responsiveness.Conclusion The primary healthcare facilities of Bharatpur, Nepal demonstrated nearly three-quarters of the respondents reporting good responsiveness of services at OPD. To further enhance the level of responsiveness, strengthening the referral networks, empowering patients in decision-making and prioritising patient satisfaction and quality of services can help.