The Influence of Health Literacy on Patients' Rights Charter on Health Systems responsiveness at a Primary Health Care facility in Machakos County

Abstract

Health systems do not always respond to legitimate non-medical needs and expectations of the patients attending for services. Responsiveness to peoples’ legitimate expectations in health systems is one of the goals of health systems. Despite its importance, few studies have documented interventions aimed at improving responsiveness in primary health care facilities. The aim of the study was to establish whether integration of an intervention of health literacy of patients’ rights into ongoing service delivery practices influenced health systems responsiveness at primary health care facilities of Machakos County. The objectives of the study were to establish the health care providers’ knowledge of patients’ rights influence on responsiveness, to establish patient’s knowledge of responsiveness and to establish the influence of literacy on patients’ rights charter on health systems responsiveness at primary health care facilities in Machakos County. A descriptive cross-sectional study design was used for objectives one and two and a quasi-experimental study design used for objective three. Data was collected using semi structured questionnaires from the 62 health care providers, 91 patients at pre-intervention and 89 patients at post-intervention. Key informant interviews with 4 facility in charges were conducted. Intervention of health literacy on patients’ rights charter was carried out using multiple methods. Pre and post-intervention data were collected and analyzed using SPSS version 25 and findings were presented as descriptive and inferential statistics. Results obtained from the health care provider indicated that they were both knowledgeable and considered health systems to be responsive, this was positively significantly associated with health systems responsiveness at (r=.700**, p < .001). and with all the individual domains of responsiveness except for the domain of access of patients to social support (r=.096, p < .46). There was no documentation of the practice of patients’ rights by the health care provider despite their level of knowledge. Post-intervention findings indicated that All variables of patients’ rights charter contributed in the test of between subjects; patients’ knowledge of their rights r2 = 77.9% (U=267, p=0.001) with an effect size of 2.6 standard deviations; the health care providers role of communication of patients’ rights r2=59.4% (U=472.5, p=0.001).Patients practice of their responsibility contributed 18.1%, (U=3753.5, p=0.379) and the effect size was 0.045 while institutional factor of mechanism of handling complaints contributed r2= 24.6% (U=472.5, p=0.001) with an effect size of 2.3 standard deviations. Health literacy had a statistically significant positive effect on responsiveness ( U=123; p ˂ 0.001) effect size 2.6.standard deviations on post-intervention findings. The null hypothesis was rejected. Conclusion: Health literacy on patient rights charter has an influence on health systems responsiveness. Recommendations for further study is for an intervention study targeting community health units to establish the influence of patients’ rights charter and health systems responsiveness in this primary health care setting.