Responsive health systems

Project Details

This program of work is centered around ‘Responsiveness’ - one of three key goals of all country health systems.

Responsiveness is defined as “the outcome that can be achieved when institutions and institutional relationships are designed in such a way that they are cognisant of and respond appropriately to the universally legitimate expectations of individuals (WHO 2000)”.

This program of work involves critical explorations of the concept of ‘health systems responsiveness’ broadly, and inquiries into each of the eight proposed elements of responsiveness broadly, and inquiries into each of the eight proposed elements of responsiveness (Dignity, Autonomy, Confidentiality, Attention, Access to Networks, Quality Of Amenities, Choice of Provider, Trust), in different parts of the world.

Graphic showing conceptual framework for Responsive Health Systems

Projects

  • RESPONSE

    The RESPONSE study seeks to identify mechanisms and approaches to improving the health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam. The study is funded by the UKRI Joint Health Systems Research Initiative and is implemented with collaborators from the Hanoi University of Public Health, Ghana Health Service, Mental Health Authority Ghana, University of Ghana, University of Leeds, and the London School Of Hygiene And Tropical Medicine (study coordinators).


    Visit the RESPONSE Project page .

  • Peoples’ expectations of responsive health systems: A case study of maternity care in Vietnam

    This project examines the engagements, expectations, and experiences of childbearing Vietnamese women in light of these social and economic shifts. The project reflects on the implications for key health system actors examining and improving health systems responsiveness, specifically within market-based health system contexts.

    Kimberly Lakin is the doctoral researcher on this project.

  • Childbearing Indian Migrant Women’s Expectations and Experiences of Care: Implications for Health System Responsiveness

    This study explores recent Indian migrant women’s expectations and experiences of maternity care in Melbourne. The study aims to generate insights that will help improve the health system’s responsiveness to the needs and expectations of all Australians, particularly recent migrants, and, to develop approaches to better study health systems responsiveness.

    The study is being implemented in collaboration with The Royal Women’s Hospital in Melbourne.

    Publications

    Lakin, K., Kane, S. A critical interpretive synthesis of migrants’ experiences of the Australian health system. Int J Equity Health 22, 7 (2023). https://doi.org/10.1186/s12939-022-01821-2

    Visit the Migrant Women’s Maternity Care  Expectations and Experiences of Care Project page .

  • What shapes the health outcomes of drug-resistant tuberculosis (DR-TB) patients in Pakistan?

    Despite projections of dramatic increases in the older adult population in low-and-middle-income countries (LMICs) in the coming decades, there has been little focus on addressing the challenges and pressures that this demographic shift will place on health systems. This project aims to contribute to generating actionable insights to help improve LMIC health systems’ responsiveness to the unique needs and expectations of the elderly.

    Dr Shazra Abbas was the doctoral researcher on this project.

    Publications

    Abbas S, Kermode M, Khan MD, Denholm J, Adetunji H, Kane S. What makes people with chronic illnesses discontinue treatment? A practice theory informed analysis of adherence to treatment among patients with drug-resistant tuberculosis in Pakistan. Int J Health Policy Manag. 2023;12:6576. doi:10.34172/ijhpm.2023.6576

  • Trust Relations in Health Systems: A case study of the Indian health system.

    The study entails a sociological analysis of trust relations within the health system, with a view to understand the nature and salience of these relations; it seeks to identify opportunities and entry points to rebuild trust and improve the responsiveness of the Indian health system. As part of the project, two papers, and a book chapter have been published. The study is being implemented in collaboration with the State Health Systems Resource Centre, Pune, India, the Gokhale Institute of Politics & Economics, Pune, India, and the School Of Sociology, Social Policy, and Social Research, University Of Kent, UK.

    Publications

    Calnan M, Kane S. Trust and the regulation of health systems: Insights from India. In: Professional Health Regulation in the Public Interest: International Perspectives. Editors: Chamberlain JM, Saks M, Dent M. The Policy Press, University of Bristol. 2018.

    Kane S, Calnan M. Erosion of Trust in the Medical Profession in India: Time for doctors to act. Int J Health Policy Manag. 2016 Nov 2; 6(1):5-8.

    Kane S, Radkar A, Calnan M. Trust and trust relations from the providers’ perspective: the case of the healthcare system in India. Indian J Med Ethics. 2015 Jul-Sep;12(3): 157-68.

Research Opportunities

Prospective PhD and Masters by Research students who are interested in the subject broadly, or in specific elements of responsivness, should contact Professor Sumit Kane via email at Sumit.Kane@unimelb.edu.au to explore opportunities.

Researchers

Professor Sumit Kane - Research group leader

Kimberly Lakin

Dr Shazra Abbas

Research Publications

Lakin K, Kane S. Peoples' expectations of healthcare: A conceptual review and proposed analytical framework. Soc Sci Med. 2022;292:114636. doi:10.1016/j.socscimed.2021.114636

Lakin K, Kane S. What can one legitimately expect from a health system? A conceptual analysis and a proposal for research and action. BMJ Glob Health. 2023;8(7):e012453. doi:10.1136/bmjgh-2023-012453

Mirzoev T, Kane S. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework. BMJ Glob Health. 2017;2(4):e000486. Published 2017 Oct 31. doi:10.1136/bmjgh-2017-000486

Abbas S, Kermode M, Khan MD, Denholm J, Adetunji H, Kane S. What makes people with chronic illnesses discontinue treatment? A practice theory informed analysis of adherence to treatment among patients with drug-resistant tuberculosis in Pakistan. Int J Health Policy Manag. 2023;12:6576. doi:10.34172/ijhpm.2023.6576

Kimberly Lakin, Dinh Thu Ha, Tolib Mirzoev, Bui Thi Thu Ha, Irene Akua Agyepong, Sumit Kane,
“We can't expect much”: Childbearing women's ‘horizon of expectations’ of the health system in rural Vietnam, Health & Place, Volume 85,2024,103166, https://doi.org/10.1016/j.healthplace.2023.103166

Do TTH, Bui QTT, Ha BTT, Le TM, Le VT, Nguyen QCT, Lakin KJ, Dang TT, Bui LV, Le TC, Tran ATH, Pham HTT, Nguyen TV. Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation StudyInt J Womens Health. 2023;15:599-609
https://doi.org/10.2147/IJWH.S404993

Research Group

Social & Cultural Dimensions of Health Systems


School Research Themes

Prevention and management of non-communicable diseases (including cancer), and promotion of mental health, Disparities, disadvantage and effective health care, Data science, health metrics and disease modeling



Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Nossal Institute for Global Health

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