Aims and scope of work
defined as the outcome that is achieved when health systems' institutions and
institutional relationships are designed in such a way that they take account of and
respond appropriately to the universally legitimate expectations of individuals.
At a conceptual level, the aim of making
responsiveness a separate goal is to measure the increase in well-being derived from
having responsive health system processes -- the measurement of health outcomes captures
the improvement in health resulting from treatments or health system processes that are
more responsive. Currently, WHO identifies eight domains of responsiveness: dignity,
autonomy, confidentiality, communication, prompt attention, access to social support
networks during care, quality of basic amenities, and choice of provider. In the Health
Systems Performance Assessment framework both the average level and inequalities in
responsiveness are measured.
Methods and measures
measurement strategy focuses on the use of household surveys to obtain information on
responsiveness. The 2000 World Health Organization multi-country household survey program
for responsiveness to-date has covered 117,960 respondents. Survey modes included
face-to-face interviews, postal surveys, and telephone surveys.
The main objective of the measurement strategy is to
measure what happens when health systems and the people they serve interact. The
survey instruments focus on obtaining reports on behaviour, events or actions of the
health system. The measurement is done from the perspective of the person the system is
designed to serve. This self report measurement, like all self-report measurement, is
confounded by the expectations and perceptions of the person reporting on the event. As a
result, a particular measurement challenge is to assess the role of the respondent's expectations
and perceptions of the event. Respondents are asked to report on and evaluate the
health system, but not asked to indicate whether they are satisfied with the
responsiveness of the system. The purpose is to try to reduce the role of expectations
which are systematically built into satisfaction questions.
The papers linked to below describe in detail
the measurement approaches and results from the WHO survey program.
|Further readings and
Responsiveness and responsiveness inequality -
Chronological list with downloads of relevant documents
Technical consultation dates
Responsiveness - Geneva, Switzerland, September 2001