Report
Kyoto University School of Public Health Short Course on November 25, 2021.
Responsiveness of Low- and Middle-Income Country Health Systems – Challenges and Opportunities

Speaker:
Associate Prof. Sumit Kane, Melbourne School of Population and Global Health, the University of Melbourne

Brief Description of the Short Course:
Health systems in low and middle-income countries have evolved in a context where the primary concerns were around ensuring availability of and access to health services. Many of these countries, particularly in Asia (e.g., Bangladesh, India, Vietnam) have since transitioned to, or are rapidly transitioning to middle income status. These countries are becoming more affluent, and their citizens are no longer satisfied with mere availability of healthcare and are demanding that health system be more responsive to their expectations. These transitions present challenges and opportunities for policy, practice, and research alike. This lecture introduced what entails a responsive health system, what elements constitute it, and the challenges and opportunities in providing responsive services and researching health systems responsiveness.

Summary:
Associate Professor Kane introduced the concept of “healthcare responsiveness” which is amongst the four outcomes or goals of a health system. According to the WHO’s definition of health system framework, the six building blocks i.e., service delivery, health workforce, information, medical products, vaccines and technologies, financing, and leadership/governance, lead to the outcomes of healthcare, including improved health, responsiveness, social and financial risk protection, and improved efficiency. In low- and middle-income countries (LMIC), increasingly, the availability of healthcare services is no longer an issue. Instead, LMIC societies and health systems are increasingly focusing on financial and social protection and responsiveness related outcomes and people expect their health system to respond appropriately to their expectations. Specifically, non-medical aspects of the care experience and the care encounter are gaining greater significance; these include and involve a greater focus on communication between healthcare provider and patients, promptness of attention, autonomy, confidentiality, amenities in health facilities, accommodation of the unique needs of different groups etc. In this context, AP Kane highlighted some of the challenges faced by LMIC health systems in being responsive; he also discussed challenges and opportunities involved in conducting cross-context comparative research on responsiveness of health systems. There were some questions from the attendees, regarding how to reduce redundancy of healthcare services provided, as well as what constitutes a success factor for LMIC health systems to improve their responsiveness.

Special Thanks to:
Associate Prof. Miho Iwakuma, Department of Medical Communication, School of Public Health, Graduate School of Medicine, Kyoto University.

Organized by:
Dr. Ayako Kohno, Program-specific Assistant Professor, Internationalization Promotion Office (IPO), Kyoto University School of Public Health