Health System Responsiveness Status: Study of Slum Areas of Ahvaz

Responsiveness is a main component of the health system which is related to the social characteristics of the society. The aim of this study was to evaluate the responsiveness of the health system in the slum areas of Ahvaz.

In this cross-sectional study, 385 residents of the marginal areas of Ahvaz city were selected by multi-stage sampling method Data were collected using Socio demographic-checklist and WHO responsiveness questionnaire. Data were analyzed in SPSS V22 applying descriptive statistics tests, Mann-Whitney, Kruskal-Wallis, ANOVA and t-test. 

The age range of the participants was 18 to 97 years with an average of (42.84±16.56). Women constituted 66% of the research population. 76% were married, 26% were illiterate and 4.4% had university education. 85.7 percent of participants under 5 million people. 66.2% used government service providers. 80% had health insurance and 15.1%  had supplementary insurance. Performance of in-patient services was better than outpatient services in terms of responsiveness. Aspect “Choice” received low score for outpatient and inpatient services. Almost 13% of respondents perceived some sort of discrimination while receiving inpatient service. Responsiveness of the participants in this study was significant relationship in all aspects with the type of service provider (charity/private/government), in the aspect of communication with the type of service provision (outpatient/inpatient), in the aspect of informed choice and confidentiality with the having supplementary insurance.  

Paying attention to the quality of facilities, access to social support and choice is suggested as a criterion with points for planning for change in order to improve the responsiveness of the health system in marginalized areas.