1. Responsiveness A vital aspect of Health 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. Protect them against financial cost of illness
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. having the provider to listen to you carefully.
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. being able to change the provider
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