2023-09-28 14:46:10 +00:00
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abstract: 'Background: Despite governments striving for responsive health systems
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and the implementation of mechanisms to foster better citizen feedback
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and strengthen accountability and stewardship, these mechanisms do not
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always function in effective, equitable, or efficient ways. There is
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also limited evidence that maps the diverse array of responsiveness
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mechanisms coherently across a particular health system, especially in
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low-and middle-income country (LMIC) contexts. Methods: This scoping
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review presents a cross-sectional `map'' of types of health system
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responsiveness mechanisms; the regulatory environment; and evidence
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available about these; and assesses what is known about their
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functionality in a particular local South African health system; the
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Western Cape (WC) province. Multiple forms of indexed and grey
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literature were synthesized to provide a contextualized understanding of
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current `formal'' responsiveness mechanisms mandated in national and
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provincial policies and guidelines (n = 379). Various forms of secondary
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analysis were applied across quantitative and qualitative data,
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including thematic and time-series analyses. An expert checking process
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was conducted, with three local field experts, as a final step to check
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the veracity of the analytics and conclusions made. Results: National,
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provincial and district policies make provision for health system
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responsiveness, including varied mechanisms intended to foster public
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feedback. However, while some are shown to be functioning and effective,
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there are major barriers faced by all, such as resource and capacity
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constraints, and a lack of clarity about roles and responsibilities.
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Most mechanisms exist in isolation, failing to feed into an overarching
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strategy for improved responsiveness. Conclusion: The lack of synergy
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between mechanisms or analysis of varied forms of feedback is a missed
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opportunity. Decision-makers are unable to see trends or gaps in the
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flow of feedback, check whether all voices are heard or fully understand
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whether/how systemic response occurs. Urgent health system work lies in
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the research of macro `whole'' systems responsiveness (levels,
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development, trends).'
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affiliation: 'Sutherns, T (Corresponding Author), Univ Cape Town, Sch Publ Hlth \&
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Med, Div Hlth Policy \& Syst, Cape Town, South Africa.
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Sutherns, Tammy; Olivier, Jill, Univ Cape Town, Sch Publ Hlth \& Med, Div Hlth Policy
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\& Syst, Cape Town, South Africa.'
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author: Sutherns, Tammy and Olivier, Jill
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author-email: tlsuth@gmail.com
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author_list:
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- family: Sutherns
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given: Tammy
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- family: Olivier
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given: Jill
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da: '2023-09-28'
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doi: 10.34172/ijhpm.2021.85
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earlyaccessdate: AUG 2021
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eissn: 2322-5939
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files: []
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journal: INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT
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keywords: 'South Africa; Health System; Responsiveness; Accountability; Feedback
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Mechanism'
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keywords-plus: 'MIDDLE-INCOME COUNTRIES; CARE; ACCOUNTABILITY; PARTICIPATION; LANGUAGE;
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BARRIER; SECTOR'
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language: English
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month: JAN
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number: 1, SI
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number-of-cited-references: '69'
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orcid-numbers: 'Olivier, Jill/0000-0001-9155-6896
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Sutherns, Tammy/0000-0001-6838-0212'
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pages: 67-79
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papis_id: 30edef70fa8988c47b3f27f20d60f934
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ref: Sutherns2022mappingmultiple
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researcherid-numbers: 'Olivier, Jill/M-9735-2015
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'
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tags:
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- review
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times-cited: '1'
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title: 'Mapping the Multiple Health System Responsiveness Mechanisms in One Local
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Health System: A Scoping Review of the Western Cape Provincial Health System of
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South Africa'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000719990000001
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usage-count-last-180-days: '2'
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usage-count-since-2013: '6'
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volume: '11'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2022'
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