BACKGROUND:
Responsiveness is a core objective of healthcare systems and focuses on the care experiences or perceptions of individuals. Health system responsiveness (HSR) includes dimensions of dignity, autonomy, confidentiality, communication, prompt attention, basic amenities, social support, and choice. These non-clinical aspects of care are critical to service quality, equitable utilisation, as well as population trust in the system. Yet, there are knowledge gaps on the HSR in First Referral Hospitals (FRHs), also known as district hospitals, that are central to supporting primary health care.

OBJECTIVE:
The purpose of this organised session is to present the results of patient experiences of care in 15 sentinel FRHs in Kenya, South Africa, and Uganda that are part of the AFRHiCARE partnership, and to stimulate a debate on HSR in FRHs.

METHODS:
Multi-country baseline assessments were conducted in 2025 at 15 sentinel FRHs. Inpatient respondents were eligible if they had been admitted for at least two days, were clinically stable, and consented to participate. Surveys were field worker-administered in the respondents’ language of choice. Questions included socio-demographic characteristics, the key dimensions of HSR, perceived quality of nursing care, and financial risk protection. We recruited 674 in-patients in Kenya, 623 in South Africa, and 766 in Uganda. This organised session will feature three 10-minutes presentation from each of the study countries on HSR, the quality of basic amenities and perceptions on nursing care in the context of hospital infrastructure, staffing, and organisational practices. A discussant will comment critically on interpreting HSR data and the implications for health service delivery. The audience will have the opportunity to engage on the concept of HSR across African countries. Expected results. Improving responsiveness is fundamental to achieving equitable and inclusive health care systems.