Health System Responsiveness for HIV/AIDS Treatment and Care Services in Shewarobit, North Shewa Zone, Ethiopia

• Published in: Patient preference and adherence 2021-01, Vol.15, p.581-588
• Main Authors: Asefa, Getachew, Atnafu, Asmamaw, Dellie, Endalkachew, Gebremedhin, Tsegaye, Aschalew, Andualem Yalew, Tsehay, Chalie Tadie
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Care and treatment; Communication; Confidence intervals; Confidentiality; Data collection; Ethics; ethiopia; Health care policy; Health facilities; health systems; HIV; HIV infection; hiv/aids; Hospitals; Human immunodeficiency virus; Original Research; Patient satisfaction; Population; Public health; Quality management; Questionnaires; responsiveness; Sample size; Sociodemographics; Surveys
• ISSN: 1177-889X; 1177-889X
• DOI: 10.2147/PPA.S300825

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. 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. 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. 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.