Health system responsiveness and its associated factors for delivery care in public health facilities of West Arsi Zone, Oromia, Ethiopia

BACKGROUND: Health System Responsiveness is defined as how well the health system meets the legitimate expectations of the population for the non-health enhancing aspects of the health system. As Ethiopia approaches the conclusion of the Health Sector Transformation Plan-II (HSTP-II), generating evidence on health system responsiveness is critical for evaluating progress and guiding future strategies. However, there remains a scarcity of empirical evidence on health system responsiveness, particularly in the context of delivery care services. OBJECTIVE: The primary aim of this study was to assess the health system responsiveness and its associated factors for delivery care in public health facilities of West Arsi Zone, Oromia, Ethiopia. METHODS: A health facility-based cross-sectional study was conducted among 617 mothers who gave birth in the selected public health facilities of West Arsi Zone, Oromia Region. Data were collected from 24/02/2025-26/04/2025. Systematic random sampling technique was used to approach study participants. Health system responsiveness was measured using eight domains namely dignity, autonomy, confidentiality, communication, prompt attention, social support, choice and basic amenities each item rated on 1-5 scale. Mothers with median score ≥112 were categorized as having good responsiveness performance for delivery care whereas