Health System Responsiveness and Client Satisfaction Among Recipients of Humanitarian Services Provided by the Iranian Red Crescent Society in Razavi Khorasan Province, Iran: A Cross-Sectional Study
| Author | Maliheh Khalvati | en |
| Author | Pirhossein Kolivand | en |
| Author | Parisa Paran | en |
| Author | Fariba Mahouti | en |
| Author | Soraya Gharebaghi | en |
| Author | Moein Hosseinkhani | en |
| Orcid | Maliheh Khalvati [0000-0002-6544-5970] | en |
| Orcid | Pirhossein Kolivand [0000-0002-0532-4130] | en |
| Orcid | Soraya Gharebaghi [0000-0003-2083-8196] | en |
| Orcid | Moein Hosseinkhani [0000-0001-7539-1497] | en |
| Issued Date | 2026-10-31 | en |
| Abstract | Background: Health system responsiveness (HSR) captures how health systems address clients' nonmedical expectations, including dignity, autonomy, confidentiality, communication, and prompt attention. Despite its recognized importance in humanitarian settings, empirical evidence on HSR and its relationship to client satisfaction in these contexts remains limited. Objectives: This study assessed HSR and client satisfaction among recipients of humanitarian services provided by the Iranian Red Crescent Society in Razavi Khorasan Province, Iran. Methods: A descriptive-analytical cross-sectional survey was conducted in 2023 across 27 counties. A multistage sampling design with convenience sampling within service strata was used to enroll 1,384 recipients of social, pharmaceutical, medical, and rehabilitation services. Data were collected using the McMurtry Client Satisfaction Scale (25 items, four domains) and the World Health Organization (WHO) HSR Questionnaire (25 items, eight domains). Exploratory factor analysis and confirmatory factor analysis were used to evaluate construct validity. Group differences were assessed using t tests and analysis of variance (ANOVA). The relationship between HSR and satisfaction was examined using Pearson correlation and analysis of covariance. Results: A total of 1,384 recipients across 27 counties were surveyed. Both instruments demonstrated sound psychometric properties (satisfaction α = 0.737; responsiveness α = 0.872), supporting a four-factor satisfaction structure (52.5% variance) and an eight-factor responsiveness structure aligned with World Health Organization (WHO) domains (62.1% variance), with good CFA fit for both. Mean scores were 76.47 (SD = 9.32) for satisfaction and 82.54 (SD = 13.06) for responsiveness. Female participants and recipients of pharmaceutical services reported higher satisfaction; no significant differences emerged by age, education, or residence. HSR and satisfaction were not significantly correlated (r = 0.02, P = 0.454), and this null association persisted after adjustment for gender and service type. Conclusions: Satisfaction and responsiveness levels were both moderate to high, although responsiveness scores were consistently higher than satisfaction scores. Contrary to expectations, HSR and client satisfaction were not significantly correlated, suggesting that these constructs capture distinct aspects of the service experience in this humanitarian context. The findings highlight social services and rehabilitation as priority areas for quality-improvement efforts within Red Crescent humanitarian programs. | en |
| DOI | https://doi.org/10.5812/mejrh-172809 | en |
| URI | https://brieflands.com/journals/mejrh/articles/172809 | en |
| Keyword | Health System Responsiveness | en |
| Keyword | Client Satisfaction | en |
| Keyword | Humanitarian Services | en |
| Keyword | Red Crescent | en |
| Keyword | Iran | en |
| Keyword | Factor Analysis | en |
| Publisher | Brieflands | en |
| Title | Health System Responsiveness and Client Satisfaction Among Recipients of Humanitarian Services Provided by the Iranian Red Crescent Society in Razavi Khorasan Province, Iran: A Cross-Sectional Study | en |
| Type | Research Article | en |