Table 3 Comparison of dominant categorizations of responsiveness in the literature
From: Health system responsiveness: a systematic evidence mapping review of the global literature
|  | Categorization 1: ‘Unidirectional user-service interface’ | Categorization 2: ‘Service feedback between users and health system’ | Categorization 3: ‘Accountability’ |
|---|---|---|---|
Responsive to whom? | Users/patients who have accessed health services | Various users (patients, patient representatives, intermediaries, those seeking access) | All: ‘citizens’, community, community representatives, patient advocates, civil society, the public, population |
How is health system responsiveness understood? | As a quality checking and service improvement indicator Responsiveness assessments on particular building blocks | Processes to obtain feedback from users and respond to the feedback at a service level – placing user experiences as central to responsiveness | A responsive health system is a product of an accountable service and system Focus on formal (and sometimes informal) mechanisms to enhance accountabilty |
Setting of focus and flow of feedback and responsive |
In facility, at point of exit measured at the level of the individual, ussually uniderectional |
Inside or outside or facility (before, during, after care) |
Various, usually peripheral to the service (‘outside’ the facility) |
Representation in the literature | 25% (155/621) Decade most published: 2011-2020 Geographic spread: mostly LMICs (76/155), HICs (26/155) Empirical/Conceptual: mostly empirical (124/155) | 40% (251/621) Decade most published: 2011-2020 Geographic spread: mostly HICs (118/251), LMICs (83/251) Empirical/Conceptual: Mostly empirical (179/251) | 32% (196/621) Decade most published: 2011-2020 Geographic spread: mostly LMIC (89/196), HIC (53/196) Empirical/Conceptual: Mostly empirical (116/196) |
Exemplar study from this category | Bramesfeld et al. provide an empirical measurement of the overall responsiveness of mental health services in Germany, comparing in and out-patients, using the WHO tool. Service responsiveness was assessed quantitively against 9 domains (attention, dignity, clear communication, autonomy, confidentiality, basic amenities, choice of provider, access to social support – and continuity) [59]. | Serapioni and Duxbury showcase Mixed Advisory Committees (MAC) as a channel for obtaining, analysing and responding to the public within the Italian health care system. The advisory committtees included public and system actors. The MAC was a deliberative and participatory public consultation approach aimed at monitoring and assessing health-care quality from users’ perspectives [60] | Andrews et al. describe a participatory collaboration to design a web-based data collection and monitoring plan for health councils to use in New Mexico. The plan was co-developed (by users and systems actors) as a mechanism for accountability. Joint evaluations were conducted to outline processes and systems-level outcomes for county council development, planning, and community action [61]. |
