HEALTH SYSTEM RESPONSIVENESS AND ASSOCIATED FACTORS AMONG ANTENATAL CARE CLIENTS IN NAIROBI CITY COUNTY, KENYA
Keywords:
Health System Responsiveness, Socio-demographic, Maternal antenatal characteristics.Abstract
Background: Health System Responsiveness (HSR) examines how well
healthcare services meet patient expectations to foster trust and satisfaction. Assessing HSR is critical to inform areas of improvement. Sociodemographic and maternal antenatal characteristics can influence patients' perceptions on responsiveness.
Objectives: This study assessed sociodemographic and maternal antenatal
characteristics influencing HSR in antenatal care facilities in Nairobi City
County, Kenya.
Design: The study used a cross-sectional analytical design to investigate
influence of sociodemographic and maternal characteristics on HSR.
Participants were selected using systematic, proportional sampling, and
validated questionnaires were used.
Setting: Data were collected between 4th -14th November 2024, from eight randomly selected sub-county health facilities in Nairobi City County.
Participants: A sample of 774 pregnant women attending antenatal clinics.
Main outcome measure: HSR rating by ante natal women attending clinic
Results: A high response rate of 100% (n=736) was achieved, where 52.7%
(n=388) perceived health system as responsive, and 47.3% (n=348) as nonresponsive. Overall HSR had mean score of 3.9 (SD=0.140) indicating nonresponsiveness. Logistic regression showed older participants (OR=2.30, 95% CI: [1.23–4.29], p=0.009), secondary education (OR=1.78, 95% CI: [1.03–3.08], p=0.039) and family support (OR=2.15, 95% CI:[1.14–4.07], p=0.018) had higher odds of perceiving responsiveness. Discomfort during pregnancy was significantly associated with responsiveness (χ²=26.909, p<.001). Mothers with more clinic visits (Mean=1.85, SD=0.876), higher gestation (Mean=5.86 weeks SD=1.907), fewer pregnancies (Mean=1.35, SD=0.548) perceived the system as
responsive.
Conclusion: Multiple socio-demographic and maternal antenatal characteristics influence perceived responsiveness, emphasizing need for tailored service delivery.
