{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T21:18:36Z","timestamp":1782508716571,"version":"3.54.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020864","name":"Madda Walabu University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020864","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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\u201326\/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\u20135 scale. Mothers with median score \u2265112 were categorized as having good responsiveness performance for delivery care whereas <112 were considered as poor responsiveness for delivery care. Data was entered and analyzed using SPSS version 25. Both bi-variable and multivariable logistic regression analysis were done to identify association between dependent and independent variables. Crude and adjusted odds ratios with respective 95% confidence intervals were computed and statistical significance was declared at p-value <0.05.<\/jats:p>\n <\/jats:sec>\n \n Result<\/jats:title>\n The overall level of good health system responsiveness for delivery care was found to be 51.4% (95% CI 47.4\u201355.4). The highest and least performance score was reported in the social support domain (62.9%) and choice domain (51.7%) respectively. Adverse neonatal outcome (AOR\u2009=\u20090.50, 95% Cl (0.31, 0.82), obstetrics complications (AOR\u2009=\u20090.47, 95% Cl (0.26, 0.85), history of admission during current pregnancy (AOR\u2009=\u20090.58, 95% Cl (0.35, 0.96) were factors significantly associated with health system responsiveness.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n More than half of the respondents reported that the overall level of health system responsiveness during delivery was good. Adverse neonatal outcome, obstetrics complications and history of admission during current pregnancy had shown statistically significant association with health system responsiveness for delivery care. Enhancing health system responsiveness during delivery needs targeted investments in infrastructure, continuous training for healthcare providers, and tailored support for women who experience adverse neonatal outcomes or obstetric complications. Strengthening these areas is essential for ensuring respectful, timely, and women centered maternity care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0340691","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T19:23:06Z","timestamp":1767813786000},"page":"e0340691","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health system responsiveness and its associated factors for delivery care in public health facilities of West Arsi Zone, Oromia, Ethiopia"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7242-1918","authenticated-orcid":true,"given":"Negeso Gebeyehu","family":"Gejo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Yohannes","family":"Bedecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon Seyife","family":"Alemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maedot Ariaya","family":"Haymete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milion Reta","family":"Regasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0061-2878","authenticated-orcid":true,"given":"Abraham Endale","family":"Geleta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4625-4861","authenticated-orcid":true,"given":"Qorinah Estiningtyas Sakilah","family":"Adnani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"pone.0340691.ref001","author":"World Health Organization","year":"2000"},{"key":"pone.0340691.ref002","author":"A Tandon","year":"2000"},{"key":"pone.0340691.ref003","author":"C Darby","year":"2003"},{"key":"pone.0340691.ref004","article-title":"What determines women\u2019s birth experiences? Applications for a benchmark","volume":"77","author":"M Scheerhagen","year":"2019","journal-title":"Performance of Maternity Care from the Client\u2019s Perspective"},{"key":"pone.0340691.ref005","author":"World Health Organization","year":"2019"},{"issue":"10140","key":"pone.0340691.ref006","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1016\/S0140-6736(18)30293-9","article-title":"Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission","volume":"391","author":"AM Starrs","year":"2018","journal-title":"Lancet"},{"key":"pone.0340691.ref007","author":"Ethiopian Public Health Institute (EPHI), Federal Ministry of Health (FMOH) E, ICF","year":"2021"},{"key":"pone.0340691.ref008","first-page":"2021","author":"Federal Ministry of Health (FMoH)"},{"key":"pone.0340691.ref009","author":"Federal Ministry of Health (FMoH)","year":"2021"},{"issue":"7","key":"pone.0340691.ref010","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-069655","article-title":"Health system responsiveness and associated factors for delivery care in public health facilities, Dessie City Administration, South Wollo zone, Ethiopia: Cross-sectional study design","volume":"13","author":"Y Bayeh","year":"2023","journal-title":"BMJ Open"},{"issue":"10","key":"pone.0340691.ref011","article-title":"Health system responsiveness in maternity care at Hadiya zone public hospitals in Southern Ethiopia: Users\u2019 perspectives","volume":"16","author":"RA Abdo","year":"2021","journal-title":"PLoS One"},{"issue":"7","key":"pone.0340691.ref012","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-082507","article-title":"Health system responsiveness and its associated factors for intrapartum care in conflict affected areas in Amhara region, Ethiopia: a cross-sectional study","volume":"14","author":"A Atnafu","year":"2024","journal-title":"BMJ Open"},{"issue":"12","key":"pone.0340691.ref013","article-title":"Health system responsiveness and its associated factors among outpatients in primary health care facilities, Asagirt District, North Shewa Zone, Ethiopia: A cross-sectional study","volume":"16","author":"WD Negash","year":"2021","journal-title":"PLOS ONE"},{"issue":"1","key":"pone.0340691.ref014","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12913-022-07516-2","article-title":"Evaluation of primary care responsiveness by people with mental illness in Spain","volume":"22","author":"V Coronado-V\u00e1zquez","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0340691.ref015","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1002\/hpm.2626","article-title":"Responsiveness of the urban primary health care delivery system in Bangladesh: A comparative analysis","volume":"34","author":"SA Hamid","year":"2019","journal-title":"Int J Health Plann Manage"},{"issue":"3","key":"pone.0340691.ref016","first-page":"123","article-title":"Responsiveness in the healthcare settings: A survey of inpatients","volume":"3","author":"A Mohammadi","year":"2014","journal-title":"International Journal of Hospital Research"},{"issue":"1","key":"pone.0340691.ref017","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s12913-020-4961-9","article-title":"Assessing health system responsiveness in primary health care facilities in Tanzania","volume":"20","author":"NA Kapologwe","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pone.0340691.ref018","doi-asserted-by":"crossref","DOI":"10.29333\/ejgm\/93481","article-title":"Responsiveness of the health system towards patients admitted to west of Iran hospitals","volume":"16","author":"P Baharvand","year":"2019","journal-title":"Electron J Gen Med"},{"key":"pone.0340691.ref019","doi-asserted-by":"crossref","first-page":"581","DOI":"10.2147\/PPA.S300825","article-title":"Health System Responsiveness for HIV\/AIDS Treatment and Care Services in Shewarobit, North Shewa Zone, Ethiopia","volume":"15","author":"G Asefa","year":"2021","journal-title":"Patient Prefer Adherence"},{"key":"pone.0340691.ref020","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.2147\/JMDH.S397735","article-title":"Process Evaluation of Health System Responsiveness Level and Associated Factors Among Mothers Gave Birth at Obstetric Ward in a Tertiary Hospital, Southwest of Ethiopia: Mixed Study Methods","volume":"16","author":"G Girma","year":"2023","journal-title":"J Multidiscip Healthc"},{"issue":"4","key":"pone.0340691.ref021","first-page":"1896","article-title":"Health system responsiveness in obstetrics and gynecology departments of teaching hospitals in Mashhad, Iran","volume":"7","author":"A Vafaee","year":"2019","journal-title":"Journal of Midwifery and Reproductive Health"},{"issue":"1","key":"pone.0340691.ref022","doi-asserted-by":"crossref","first-page":"1850058","DOI":"10.1080\/16549716.2020.1850058","article-title":"Migrants\u2019 perceptions of health system responsiveness and satisfaction with health workers in a South African Province","volume":"13","author":"JA White","year":"2020","journal-title":"Glob Health Action"},{"key":"pone.0340691.ref023","article-title":"What determines women\u2019s birth experiences? Applications for a benchmark","volume-title":"Performance of maternity care from the client\u2019s perspective","author":"M Scheerhagen","year":"2019"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T19:23:16Z","timestamp":1767813796000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0340691"}},"subtitle":[],"editor":[{"given":"Engidaw Fentahun","family":"Enyew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0340691","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]}}}