Responsiveness of services rendered at primary healthcare facilities of Bharatpur, Nepal: a cross-sectional study.

Introduction: Responsiveness of services refers to the way healthcare systems and providers interact with patients and how well they meet patients' non-clinical expectations and needs. The responsiveness is a crucial aspect of a well-functioning health system while primary healthcare is considered as its foundational cornerstone. However, in low and middle-income countries, there are numerous obstacles to its efficient operation and a very limited understanding of the concept of service responsiveness. This study aimed to assess the responsiveness of services and identify associated factors at primary healthcare facilities of Bharatpur, Nepal. Methods: A facility-based cross-sectional study was carried out among 358 patients visiting outpatient department (OPD) of primary healthcare facilities of Bharatpur. A pretested structured interview schedule was used to conduct a face-to-face interview to obtain the information per the study's objective. Univariate as well as bivariable and multivariable logistic regressions were carried out to obtain the result per our objectives. Results: The overall performance of the responsiveness of services was 74.6% (95% CI 70.1 to 78.8), dignity being the highest performing domain (97.2%) and choice being the lowest (22.6%). Respondents aged more than or equal to 50 (adjusted OR (AOR)=4.107, 95% CI 1.28 to 13.14), those who are satisfied with the service (AOR=7.02, 95% CI 3.21 to 15.36), those who perceive high quality of care (AOR=5.69, 95% CI 2.54 to 12.73) and those who did not have to pay for transportation (AOR=4.63, 95% CI 2.20 to 9.72) showed higher responsiveness. Conclusion: The primary healthcare facilities of Bharatpur, Nepal demonstrated nearly three-quarters of the respondents reporting good responsiveness of services at OPD. To further enhance the level of responsiveness, strengthening the referral networks, empowering patients in decision-making and prioritising patient satisfaction and quality of services can help.