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Table 5 Mechanisms that potentially support health system responsiveness (organized by publication prominence)

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

Mechanism / feedback

Total in sub-cluster

Underlying research themes within publications

Example of this mechanism

Satisfaction surveys/ experience or quality of care surveys (formal)

82/301 (27%)

Designing surveys/ tools to measure;

Empirical measurement of indicators;

Response from and within the system or interventions informed by this mechanism

Saadat et al. examines the relationship between a healthcare reform plan and patient satisfaction in hospitals in Iran [137]

HFCs and hospital boards (formal)

54/301 (18%)

Legitimizes HFCs in HS, roles and responsibilities; Describes implementation, functioning and processes of mechanism;

Impact shown on health services, health outcomes, participation and accountability

Oguntunde et al. assess the effectiveness of HFC (as an intervention) to increase access and utilization of Maternal and Child services in Nigeria [139]

Complaint management procedures (formal)

41/301 (14%)

Complaint management process; complaint analysis across time or cross-sectional;

Response from and within the system or interventions informed by this mechanism

Gurung et al. analyzed complaint management systems in primary health care in Nepal [18]

Scorecard/Report Cards (formal)

37/301 (12%)

Development of scorecard; Implementation and measuring effect of this mechanisms

Ho et al. document the implementation of community scorecards in two provinces of Democratic Republic of Congo [140]

Incident reporting (formal)

32/301 (11%)

Incident reporting practices and analysis; Interventions to improve incident reporting; Barriers and facilitators for incident reporting

Gallagher and Kupas, analyzed emergency medical services safety incidents reported on an anonymized web-based reporting system 2003–2010 [141]

Community Monitoring (formal)

22/301 (7%)

Technical/theoretical literature on accountability via community monitoring; Documents implementation, and evaluates impact of this mechanism

Shukla and Sinha documents CB monitoring implementation in India, highlighting effects on community mobilization and quality of care [129]

Data systems (formal)

18/301 (6%)

Patient views on data system items; Designing and test interfaces/tools to engage user involvement in systems development; Response from the system

Andrews et al. conducted participatory evaluation to create an online data collection and monitoring system for New Mexico’s Community Health Councils [132]

Intersectoral collaboration (formal)

18/302 (6%)

Technical or theoretical literature; Effects on system change

Janse van Rensburg et al. explore extent and nature of state/non-state mental health service collaboration in South Africa [142]

Social media (informal)

17/302 (6%)

Feedback on experiences of services; Enabling patient participation, monitoring and decision-making

Antheunis et al. examines patients’/professionals’ motives for using social media in health care and barriers and expectations for health-related social media use in the Netherlands [143]

Social Audits (formal)

9/302 (3%)

Technical or theoretical literature on accountability that include this mechanism;

Implementation of mechanism

Schaaf et al. conduct a realist analysis on the implementation of Citizen Voice and Action program implemented in Zambia [144]

Medico-Legal (formal)

9/302 (3%)

The role of judiciaries in enforcing rights;

Analysis of litigation cases

Biehl et al. analyzed lawsuits filed against the state in Brazil, affirming the heterogeneity of the judicialization phenomenon [145]

Patient Charters (formal)

8/302 (3%)

Implementation of this mechanism

Gurung et al. investigate level of awareness of a Charter and implementation factors in Nepal’s primary health care system [146]

Citizen Juries (formal)

5/302 (2%)

Decision-making and policy formation;

Health research priorities

Chuengsatiansup et al. examine how citizens’ jury enhance public participation in the development long-term care policy for elders in Thailand [147]

Ombud (formal)

3/302 (1%)

Role of ombudsman in complaint management procedure

Gil analyses context of complaints and assessment of institutional violence towards older people by National Inspection Service in Portugal [148]

Media (informal)

2/302 (1%)

User views/ feedback interface and complaints; Health advocacy

Cullinan describes implementation of pilot study (OurHealth) on civic journalism in South Africa [149].

Social protests (informala)

2/302 (1%)

Protests action by the public as feedback; Response from system

Sri et al. documents maternal death investigation as response to protest action in India [150]

  1. a We acknowledge that there may be protests that are mandated, however we are regarding social protests as an ‘informal mechanism’ given they generally do not request feedback, and also fall outside of what traditionally has been considered as an example of health policy and/or related legislation