Responsiveness A vital aspect of Health Systems

1
ResponsivenessA vital aspectofHealth Systems

• Dr S Sridharan
• Ministry of Health
• Colombo 08
• Sri Lanka

2
Health Systems

• Goals
• Improving the health of the population they
  serve
• Responding to peoples expectations
• Providing financial protection against the cost
  of ill health
• 2

3
Measuring to Assess a Health System

• Overall level of health
• Distribution of health in the population
• Institutions with overall level of responsiveness
• Distribution of such institutions with
  responsiveness
• Distribution of financial contribution
• 3

4
World Health Report 2000 page 31

• Some systems are highly unresponsive
• A common complaint in many countries about public
  sector health workers
• focus on
• their rudeness in relation with patients
• 4

5
Responsiveness

• Reducing the damage to ones dignity and autonomy
  and the fear and shame that sickness often brings
  with it
• Treat the people with individual dignity
• Their needs should be promptly attended to
  minimise long delays in waiting for diagnosis and
  treatment
• 5

6

• Respect the value of peoples time and reduce
  their anxiety
• Ensure confidentiality
• Allow choices
• Treat them with dignity
• Ensure there is no error, delays, rudeness,
  hostility and indifference by the health worker
• Protect them against financial cost of illness
• 6

7

• Ensure there is no error, delays, rudeness,
  hostility and indifference by the health worker
• Protect them against financial cost of illness
• 7

8
Responsiveness

• Is not a measure of how the system responds to
  health needs which shows up in health outcomes
• but,
• of how the system performs relative to non
  health aspects meeting or not meeting a
  populations expectations of how it should be
  treated by providers of prevention, curative or
  non personal services.
• 8

9
World Health Report 2000 page 33

• the poor was identified as the main
• disadvantaged group. They are treated with
• less respect for their dignity to have less
• choice of providers to be offered poorer
• quality amenities (basic needs) than the non
• poor. They were granted as being treated
• worse than urban dwellers

10
Elements of Responsiveness

• Respect for persons
• Dignity
• Being shown respect
• Maintaining privacy during physical examination
• Confidentiality of information
• Medical history kept confidential
• Consulting with health providers in a manner that
  your discussions could not be overheard
• 10

11

• Autonomy
• Being involved in deciding on your case and
  treatment if you want to
• Having the providers ask your permission before
  starting treatments or tests
• 11

12

• 4. Communication
• having the provider to listen to you carefully.
• having the provider explain things so you can
  understand
• having patients to ask questions
• 12

13

• Client orientation
• 5. Prompt attention
• Having health care provider within reasonable
  distance and travel time form home
• Duties and treatments
• Having fast care in emergencies
• Having short working times for appointments and
  consultations and getting test done
• 13

14

• 6. Quality of basic amenities
• Enough space, seating, fresh air in waiting rooms
  and wards
• Clean facilities ( toilets, eating places)
• Clean healthy food
• Having short waiting list for non emergency cases
• 14

15

• Social support during care
• - being allowed visits from relatives and
  friends
• - being allowed provision of food and other
  gifts
• from relatives
• - having freedom for religious practices
• 15

16

• 7. Choice of provider
• being able to chose the doctor or other person
  providing you health care
• being able to change the provider

17
Thank you