![]() ![]() Responsiveness, nowadays a well-recognised key objective of national health systems, 1 2 was explicitly introduced in the World Health Report 2000. While we hope to trigger further thinking on the conceptualisation of health system responsiveness, the proposed framework can guide assessments of, and interventions to strengthen, health systems responsiveness. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper contributes to a growing, yet limited, knowledge on this topic. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Responsiveness is a key objective of national health systems. ![]()
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