Who are more responsive? Mixed-methods comparison of public and private sector physicians in rural Bangladesh

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Date
2017Author
Joarder, Taufique
George, Asha
Sarker, Malabika
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Responsiveness of physicians (ROPs) reflects the social actions by physicians to meet the legitimate expectations of health care users. Responsiveness is important since it improves understanding and care seeking by users, as well as fostering trust in health systems rather than replicating
discrimination and entrenching inequality. Given widespread public and private sector health care
provision in Bangladesh, we undertook a mixed-methods study comparing responsiveness of public and private physicians in rural Bangladesh. The study included in-depth interviews with physicians (n ¼ 12, seven public, five private) and patients (n ¼ 7, three male, four female); focus group
discussions with users (four sessions, two male and two female); and observations in consultation
rooms of public and private sector physicians (1 week in each setting). This was followed by structured observation of patient consultations with 195 public and 198 private physicians using the
ROPs Scale, consisting of five domains (Friendliness; Respecting; Informing and guiding; Gaining
trust; and Financial sensitivity). Qualitative data were analysed by framework analysis and quantitative data were analyzed using two-sample t-test, multiple linear regression, multivariate analysis
of variance, and descriptive discriminant analyses.