Thematic analysis revealed eight primary conceptualizations of ‘health system responsiveness’, which can be fitted into three dominant categorizations: 1) unidirectional user-service interface 2) responsiveness as feedback loops between users and the health system and 3) responsiveness as accountability between public and the system. Most were empirical studies ( n = 424/621) utilized quantitative methodologies ( n = 232), while qualitative ( n = 127) and mixed methods ( n = 63) were more rare. Most of the publications were from Europe ( n = 139), with more publications relating to High Income Countries ( n = 241) than Low-to-Middle Income Countries ( n = 217). Evidence mapping shows substantially more publications between 20 ( n = 462/621) than earlier periods. Six hundred twenty-one publications were included in the review.
#Responsiveness health system indicators full#
We screened titles and abstracts of 1119 publications and 870 full texts. Published and grey literature conceptual and empirical publications published between 20 and English language texts were included. We searched PubMed, EbscoHost, and Google Scholar. MethodsĪ mixed method systemized evidence mapping review was conducted. We therefore sought to map existing evidence on health system responsiveness. There is an urgency to make systems more responsive, but our understanding of responsiveness is limited. Responsiveness is essential to strengthen systems’ functioning provide equitable and accountable services and to protect the rights of citizens. However, of the three, responsiveness received significantly less attention. The World Health Organisation framed responsiveness, fair financing and equity as intrinsic goals of health systems.
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