ArticleInternational journal for equity in health2020
Responsiveness of health care services towards the elderly in Tanzania: does health insurance make a difference? A cross-sectional study.
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 28 citations in OpenAlex.
- Health system responsiveness to older adults with functional limitations and socio-economic vulnerability in India.Global health action · 2026Article
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- Factors influencing health service utilisation among older adults in the Tamale metropolis: a cross-sectional study based on Andersen's behavioural model.BMC geriatrics · 2025Article
- Health systems responsiveness in low and middle-income countries (L&MICs): revisiting its scope.BMJ open quality · 2025Article
- Social health insurance, family support, and chronic diseases as determinants of health service utilization among senior citizens in rural Nepal.BMC public health · 2025Article
- Psychometric Evaluation of the Chinese Version of the Mental Health System Responsiveness Questionnaire for Psychiatric Outpatients: Classical Test Theory and Item Response Theory Approaches.Patient preference and adherence · 2025Article
- Rethinking Health Systems Responsiveness in Low- and Middle-Income Countries: Validation Study.JMIR research protocols · 2024Article
- Responsiveness of services rendered at primary healthcare facilities of Bharatpur, Nepal: a cross-sectional study.BMJ public health · 2024Article
- Health care prioritization process for the elderly in rural Tanzania under decentralized system: Prospects and challenges.PloS one · 2024Article
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- Healthcare workers´ experiences and perceptions of the provision of health insurance benefits to the elderly in rural Tanzania: an explorative qualitative study.BMC public health · 2023Article
- Patient-Perceived Health System Responsiveness of the Epilepsy Management Project in Rural China during the Period of COVID-19.Healthcare (Basel, Switzerland) · 2022Article
- Health system responsiveness and associated factors among outpatients in primary health care facilities in Ethiopia.BMC health services research · 2022Article
- Health insurance and health system (un) responsiveness: a qualitative study with elderly in rural Tanzania.BMC health services research · 2021Article
- Unmet Needs of Healthcare Services and Associated Factors among a Cohort of Ghanaian Adults: A Nationally Stratified Cross-Sectional Study Design.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
6 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundResponsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients' expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population.
methodsA community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors.
resultsA total of 1453 and 744 elderly, of whom 50.1 and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (- 1; 95% CI: - 1.45, - 0.45) and inpatient (- 2; 95% CI: - 2.69, - 1.30) care.
conclusionThe uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.
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