Asefa Getachew, Atnafu Asmamaw, Dellie Endalkachew, Gebremedhin Tsegaye, Aschalew Andualem Yalew, Tsehay Chalie Tadie
Shewarobit Primary Hospital, Shewarobit, North Shewa Zone Administration, Amhara National Regional State, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Patient Prefer Adherence. 2021 Mar 9;15:581-588. doi: 10.2147/PPA.S300825. eCollection 2021.
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.
卫生系统响应性是卫生系统用于满足患者普遍合理期望的关键目标。然而，埃塞俄比亚尚未对卫生系统对艾滋病毒/艾滋病的响应性进行评估。因此，本研究旨在评估埃塞俄比亚舍瓦罗比特镇公共卫生设施中艾滋病毒/艾滋病治疗和护理服务的卫生系统响应性及相关因素。
2020年2月15日至4月15日，在舍瓦罗比特镇的公共卫生设施中开展了一项基于机构的横断面研究。通过访谈式问卷对416名随机选取的抗逆转录病毒疗法（ART）使用者进行数据收集。使用涵盖七个响应性领域的27个李克特量表问题来衡量响应性。拟合二元逻辑回归模型。在最终的多变量逻辑回归分析中，p值小于0.05且带有95%置信区间（CI）的调整后比值比（AOR）用于确定相关因素。
卫生系统总体响应性为55.3%（95%CI：50.6 - 59.8）。在保密性、尊重和沟通领域发现响应性表现良好，而在及时关注和选择领域响应性较差。50岁及以上的参与者（AOR：2.48，95%CI，1.12 - 5.54）、自我感觉健康状况良好（AOR：3.10，95%CI：1.75 - 5.48）、患者对护理的满意度（AOR：2.98，95%CI：1.35 - 6.54）以及曾拜访传统治疗师的经历（AOR：2.50，95%CI：1.51 - 4.17）是与研究地区艾滋病毒/艾滋病治疗和护理服务的卫生系统响应性相关的因素。
在选择和及时关注领域发现了不可接受的响应性表现。参与者的年龄、自我感觉的健康状况、拜访传统治疗师的经历以及患者满意度是影响研究地区响应性的因素。因此，提供培训、频繁进行支持性监督、提高社区意识以及将传统治疗师纳入现代卫生系统将提高埃塞俄比亚的卫生系统响应性。
