Girma Gezu, Tamire Aklilu, Edessa Gebeyehu Jeldu, Dechasa Mesay, Tefasa Obsan Kassa, Negash Abraham, Dereje Jerman, Masrie Awoke, Shawel Samrawit, Mandefro Miheret, Abraham Gelila
Department of Health Research, International Center for AIDS Care and Treatment Program (ICAP), Finfine, Ethiopia.
School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Harari, Ethiopia.
J Multidiscip Healthc. 2023 Aug 14;16:2291-2308. doi: 10.2147/JMDH.S397735. eCollection 2023.
The term responsiveness emerged during the World Health Organization (WHO) report in 2000 as new and essential goals of the health systems to meet the needs of people to their expectations from different services being given in healthcare systems. Obstetric violence and childbirth mistreatment are global problems, but the worst obstetric violence usually occurs in underdeveloped countries. Thus, the main objective of this study was to evaluate the responsiveness of obstetric service at Jimma University Medical Center.
A single-case study design with quantitative and qualitative data collection was employed. Availability with 17 indicators and health system responsiveness with 24 indicators were used. Consecutive sampling technique was used to select the clients and qualitative data were collected from key informants. SPSS version 25 was used for the analysis of quantitative data, whereas thematic analysis was conducted for qualitative data. A multiple linear regression model was fitted after all assumptions were checked and fit to ensure the relation of the dependent variable with independent variables.
The overall evaluation was 75.6% and judged good. The resource availability and health system responsiveness were 85.5% and 69.7%, which were judged very good and fair, respectively. A stethoscope and thermometer were not available, while 40% glucose, dexamethasone, and intravenous fluid were the most frequently stocked-out supplies. Dignity (72.1%), confidentiality (71.4%), and prompt attention (70%) were the top three good scores for the health system's responsiveness. Health system responsiveness significantly associated with the following: Not attending formal education, attending college and above, place of delivery (health center), mode of delivery (cesarean section), and being merchant.
CONCLUSION & RECOMMENDATION: The health system responsiveness of delivery service in study setting was good. All stakeholders should work for improving the health system's responsiveness in delivery service.
“响应性”一词在世界卫生组织2000年的报告中出现，成为卫生系统新的重要目标，以满足人们对医疗系统提供的不同服务的期望。产科暴力和分娩虐待是全球性问题，但最严重的产科暴力通常发生在欠发达国家。因此，本研究的主要目的是评估吉姆马大学医学中心产科服务的响应性。
采用单案例研究设计，收集定量和定性数据。使用了17项指标的可及性和24项指标的卫生系统响应性。采用连续抽样技术选择客户，并从关键信息提供者处收集定性数据。使用SPSS 25版分析定量数据，而定性数据采用主题分析。在检查并拟合所有假设后，建立多元线性回归模型，以确保因变量与自变量之间的关系。
总体评价为75.6%，判定为良好。资源可及性和卫生系统响应性分别为85.5%和69.7%，分别判定为非常好和一般。听诊器和温度计不可用，而40%葡萄糖、地塞米松和静脉输液是最常缺货的用品。尊严（72.1%）、保密性（71.4%）和及时关注（70%）是卫生系统响应性得分最高的前三项。卫生系统响应性与以下因素显著相关：未接受正规教育、接受大专及以上教育、分娩地点（保健中心）、分娩方式（剖宫产）和职业为商人。
研究环境中分娩服务的卫生系统响应性良好。所有利益相关者应努力提高分娩服务中卫生系统的响应性。
