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A critical assessment of the WHO responsiveness tool: lessons from voluntary HIV testing and counselling services in Kenya

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dc.contributor.author Njeru, Mercy Karimi
dc.contributor.author Blystad, Astrid
dc.contributor.author Nyamongo, Isaac K.
dc.contributor.author Fylkesnes, Knut
dc.date.accessioned 2011-07-15T08:41:00Z
dc.date.available 2011-07-15T08:41:00Z
dc.date.issued 2009-12-22
dc.identifier.citation BMC Health Services Research 9(243) en_US
dc.identifier.issn 1472-6963
dc.identifier.uri http://dx.doi.org/10.1186/1472-6963-9-243
dc.identifier.uri http://hdl.handle.net/1956/4839
dc.description.abstract Background: Health, fair financing and responsiveness to the user's needs and expectations are seen as the essential objectives of health systems. Efforts have been made to conceptualise and measure responsiveness as a basis for evaluating the non-health aspects of health systems performance. This study assesses the applicability of the responsiveness tool developed by WHO when applied in the context of voluntary HIV counselling and testing services (VCT) at a district level in Kenya. Methods: A mixed method study was conducted employing a combination of quantitative and qualitative research methods concurrently. The questionnaire proposed by WHO was administered to 328 VCT users and 36 VCT counsellors (health providers). In addition to the questionnaire, qualitative interviews were carried out among a total of 300 participants. Observational field notes were also written. Results: A majority of the health providers and users indicated that the responsiveness elements were very important, e.g. confidentiality and autonomy were regarded by most users and health providers as very important and were also reported as being highly observed in the VCT room. However, the qualitative findings revealed other important aspects related to confidentiality, autonomy and other responsiveness elements that were not captured by the WHO tool. Striking examples were inappropriate location of the VCT centre, limited information provided, language problems, and concern about the quality of counselling. Conclusion: The results indicate that the WHO developed responsiveness elements are relevant and important in measuring the performance of voluntary HIV counselling and testing. However, the tool needs substantial revision in order to capture other important dimensions or perspectives. The findings also confirm the importance of careful assessment and recognition of locally specific aspects when conducting comparative studies on responsiveness of HIV testing services. en_US
dc.language.iso eng en_US
dc.publisher BioMed Central en
dc.rights Copyright 2009 Njeru et al; licensee BioMed Central en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title A critical assessment of the WHO responsiveness tool: lessons from voluntary HIV testing and counselling services in Kenya en_US
dc.type Journal article en_US
dc.type Peer reviewed en_US
dc.subject.nsi VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Communicable diseases: 776 en_US
dc.rightsHolder Njeru et al; licensee BioMed Central en_US
dc.type.version publishedVersion en_US


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