Accepted for/Published in: JMIR Research Protocols
Date Submitted: Apr 23, 2024
Open Peer Review Period: Apr 23, 2024 - Jun 18, 2024
Date Accepted: Jul 23, 2024
(closed for review but you can still tweet)
Rethinking Health Systems Responsiveness in Low-and Middle-Income Countries: A Validation Study
ABSTRACT
Background:
Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by WHO includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks and clarity of communication. The WHO tool is globally applied to assess HSR in low, middle, and high-income countries.
Objective:
We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for L&MICs. This study is designed to (a) run Delphi technique to validate the upgraded conceptual framework of HSR, (b) modify and upgrade the WHO measurement tool for assessing HSR in the context of L&MICs and (c) determine validity of the upgraded HSR measurement tool by pilot testing in Pakistan.
Methods:
The survey (objective 3) follows a mixed method study design and will be carried out in primary, secondary and tertiary care hospitals of district Rawalpindi, Pakistan. Delphi technique is carried being carried out with global public health experts. The WHO measurement tool will be modified by research team in concordance will the conceptual framework after incorporating opinion of subject experts. The modified tool will be pilot tested by administering to 1,128 participants from primary, secondary and tertiary care hospitals of district Rawalpindi, Pakistan. HSR assessment will be potentiated by in-depth interviews with service providers, hospital managers and policymakers (supply side), community representatives (demand side); and observation of health facilities. The study will be carried out from Jun 2024 to Feb 2025.
Results:
A multi-dimensional approach will yield significant quantifiable information on HSR from the demand and supply side in L&MICs
Conclusions:
This study will provide conceptual understanding of HSR and a corresponding measurement tool specific for L&MICs. It will contribute to global public health literature and provide a snapshot of HSR in district Rawalpindi, Pakistan, with concrete action points for policymakers.
Citation
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