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Table 2 Explicit conceptualizations of health system responsiveness

From: Health system responsiveness: a systematic evidence mapping review of the global literature

Key features or components of conceptualizations

‘Impact’ of conceptualization in the literature

WHO responsiveness framing: responsiveness as performance goal: 2 categories (respect for patients, patient orientation); 8 domains:

â–ª Dignity of a patient; confidentiality of information; autonomy; prompt attention; quality of the amenities; choice of provider; provider-patient communication; social support networks (for in-patients)

â–ª Origin: Stems from WHR2000 [2]

â–ª Linked tools: Data collection tool available to measure responsiveness

â–ª Traction of idea: Some adaptations suggested for contexts and specific conditions [56, 57]

WHO responsiveness framing: through a rights-based lens: Adaptation of WHO framing, going further to recognizes that human rights/principles should enhance responsiveness through:

â–ª A synergy of interrelated domains namely 1) protecting rights and maintaining health; 2) authority and accountability; and 3) cohesion

â–ª Origin: Gostin et al. offer an adaptation, a conceptual lens to understand responsiveness [202]

â–ª Linked tools: Does not provide a tool to measure responsiveness

â–ª Traction of idea: No other related empirical work

Health System Responsiveness Assessment Information System (HS-RAIS): A Framework to measure responsiveness of the information system building block consisting of 10 components:

â–ª Minimum datasets; data sources; data gathering; data analysis; feedback and dissemination; legislative needs; objectives of health system responsiveness assessment; repetition period; executive committee; stewardship

â–ª Origin: Fazaeli et al. offer a framework developed after assessing responsiveness of Information Systems in Iran [1]

â–ª Linked tools: Tool adapted from WHO tool, for evidence-based decision-making

â–ª Traction of idea: No empirical studies found utilizing/testing this idea of responsiveness

Provider responsiveness for HRH: Conceptual framework to examine provider responsiveness (HRH lens). 5 domains:

â–ª Friendliness; Respect; Informing and guiding; Gaining trust; Financial sensitivity

â–ª Origin: Joarder proposes components of provider responsiveness [54], based on the WHO framing

▪ Linked tools: Provides a questionnaire to measure physicians’ responsiveness

â–ª Traction of idea: The responsiveness tool developed was used to empirically compare the responsiveness of public and private physicians in rural Bangladesh.

System-wide determinants of responsiveness: Analytic framework to understand system-wide determinants of responsiveness consisting 4 components:

â–ª Environment; Characteristics of population; Access/utilization; Responsiveness

â–ª Origin: Robone et al. offer an adaptation based on WHR2000 [53]

â–ª Linked tools: Does not provide a tool to measure responsiveness

â–ª Traction of idea: The framework was developed to analyze determinants of responsiveness in 66 countries

Responsiveness as social accountability: Framing and tool to analyze key relationships of accountability and mechanisms that enhance service responsiveness, comprising 4 mechanism types:

â–ª Delegation; Compact (service, policy stakeholders); Voice of citizens; Client power

â–ª Origin: Garza used the World Bank model of relationships for accountability [58]

â–ª Linked tools: Does not provide a tool to measure responsiveness

▪ Traction of idea: Model was empirically and analytically employed to analyze Mexico’s HS and three reforms

Social accountability initiatives for health providers responsiveness

â–ª Provider responsiveness is an outcome of citizen engagement and oversight measures

â–ª Responsiveness specifically defined as the actual changes/ improvements implemented at service/program level

â–ª Origin: Lodenstein et al. develops this conceptualization out of a realist review, emphasizing context-specificity in regard to social accountability initiatives [13]

â–ª Linked tools: Does not provide a tool to measure responsiveness

â–ª Traction of idea: No empirical studies found utilizing/testing this idea of responsiveness

Responsiveness as users’ experiences of HS interaction

▪ Present factors that shape users’ expectations as well as the systems response. The experience of the interaction is central to responsiveness.

â–ª Origin: Mirzoev and Kane offer this conceptualization out of a scoping review, which recognizes historical, political, cultural and socioeconomic context of people-system interaction [14]

â–ª Linked tools: Does not provide a tool to measure responsiveness

â–ª Traction of idea: No empirical studies found utilizing/testing this idea of responsiveness