Assessment of health system responsiveness in delivering HIV and AIDS care services at Urban sites of Pakistan - a protocol for cross sectional study.

Abstract

The capacity of a health system to fulfill the justifiable demands of patients and their caregivers while delivering prompt, courteous and patient-centered treatment is known as health system responsiveness (HSR). HSR can be considered as a measure for the quality of the health system. Keeping aside the clinical aspects of healthcare, it focusses on the health system's capacity to meet the needs of patients in accordance with ethical values and service standards. HSR is comprised of eight major dimensions including autonomy, dignity, confidentiality, timely attention, communication, facility quality, social support network accessibility and provider choice. An analytical cross-sectional study will be conducted in three public anti-retroviral therapy (ART) centres of Karachi, Pakistan, and will continue for a period of 12 months using purposive sampling technique. A sample size of 381 individuals is calculated, and patients aged >18 years, on treatment for the past 12 months will be included. Face-to-face interviews will be carried out by trained interviewers after obtaining informed consent in the local language. Descriptive statistics will be presented alongside binary logistic regression analysis. Written and informed consent will be taken from each participant before enrolment. This study is approved by the ethical review committee at the Aga Khan University Hospital (Ref No: 2024-9960-31694), and official permission has been obtained by the additional district health officer of the local government. We will disseminate the findings to stakeholders at the provincial government, private institutions, local and international conferences and a peer-reviewed journal.