Assessing Health System Responsiveness in Iraq: A Comprehensive Evaluation through Cross-Sectional Study.

Background: Responsiveness is an indicator by the World Health Organization (WHO) to evaluate the performance of health systems on nonmedical expectations of consumers. This study aimed to assess the responsiveness of the health system in Iraq, focusing on urban and rural populations across 6 provinces: Baghdad, Wasit, Karbala, An-Najaf, Babil, and Maysan.

Methods: A cross-sectional study design was employed, involving a total population of 2400 individuals from 400 households in each province. Cluster sampling was utilized to select participants, with data collected using the World Health Organization's "Global Health Survey" questionnaire, which assesses 7 dimensions of health system responsiveness. These data were analyzed using Stata Version 17 to examine statistical relationships, while Microsoft Excel was used to generate visualizations. Descriptive statistics included frequencies and percentages for qualitative variables, and means with standard deviations for quantitative variables.

Results: The findings revealed a high prioritization among respondents for the following aspects of health system responsiveness: quality of facilities (95%), confidentiality of personal information (93.71%), and prompt attention (90.72%). Clarity of communication (61.79%) and autonomy (60.91%) were rated as the most favorable dimensions, while prompt attention (58.94%) and quality of facilities (55.46%) received the lowest ratings. Experiences of discrimination were prevalent, with 34.50% reporting discrimination based on financial status, 26.87% based on social class, and 21.37% based on sex.

Conclusion: The study underscores the urgent need for improvements in health system responsiveness in Iraq, particularly in areas such as prompt response and service quality. Addressing these issues is crucial for enhancing the overall effectiveness and equity of healthcare services in the region.