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Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province

Roya Malekzadeh (Department of Public Health, Mazandaran University of Medical Sciences, Sari, Iran)
Samereh Yaghoubian (Hekmat Hospital, Mazandaran Social Security Organization, Sari, Iran)
Edris Hasanpoor (Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran)
Matina Ghasemi (Faculty of Business and Economics, Girne American University, Girne, Turkey)

International Journal of Human Rights in Healthcare

ISSN: 2056-4902

Article publication date: 19 January 2021

Issue publication date: 4 June 2021




Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran.


The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section.


All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy.


In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.



The authors would like to thank the hospitals of Mazandaran province at Mazandaran University of Medical Sciences for collaboration in the project. Conflict of interest: The authors declare that there is no conflict of interests.


Malekzadeh, R., Yaghoubian, S., Hasanpoor, E. and Ghasemi, M. (2021), "Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province", International Journal of Human Rights in Healthcare, Vol. 14 No. 2, pp. 133-142.



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