Measuring the performance of health systems has become a key tool in aiding decision makers to describe, analyze, compare and ultimately improve the delivery and outcomes achieved by a system. The World Health Organization’s (WHO) framework for assessing performance includes three intrinsic goals of health systems, namely health improvement, fairness in financial contribution and responsiveness to user preferences. Broadly speaking health system responsiveness can be defined as the way in which individuals are treated and the environment in which they are treated, encompassing the notion of patient experience. Perhaps the most ambitious attempt to implement a cross-country comparative instrument aimed at measuring health system performance ...