Health system responsiveness for delivery care in Southern Thailand

Objective. To assess the perception of women who gave birth in a hospital on health system responsiveness and their satisfaction. Design. A cross-sectional study. Setting. Four district, one regional and one university hospitals in the Songkhla province, Southern Thailand. Participants. All women who delivered in the participating hospitals from November 2007 to December 2008. Methods. All women were interviewed at 24- or 48-h post partum by well-trained interviewers who worked independently outside the hospital. Main Outcome Measures. Eight components of health system responsiveness were measured. The factors associated with high rate of health responsiveness and its effect on the women’s satisfaction was estimated by multiple logistic regres-sion. Results. A total of 2822 women were interviewed and their ages ranged from 12 to 48 years (mean+ SD: 27.6+ 6.3). The components of health system responsiveness, which influenced the women’s decision for delivering in a hospital were, in the order of importance, prompt attention, dignity, clear communication, autonomy, basic amenities, confidentiality, choice of pro-vider and social support. The majority of women (.80%) gave high ratings for dignity, clear communication, prompt atten