What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh

Responsiveness entails the social actions by health providers to meet the legitimate expectations of patients. It plays a critical role in ensuring continuity and effectiveness of care within people centered health systems. Given the lack of contextualized research on responsiveness, we qualitatively explored the perceptions of outpatient users and providers regarding what constitute responsiveness in rural Bangladesh. An exploratory study was undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4), and observations of patient provider interactions (three weeks). Analysis was guided by a conceptual framework of responsiveness, which includes friendliness, respecting, informing and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected physicians to greet them before starting consultations; even though physicians considered this unusual. Patients also expected physicians to hold social talks during consultations, which was uncommon. With regards to respect patients expected physicians to refrain from disrespecting them in various ways; but also by showing respect explicitly. Patients also had expectations related to informing and guiding: they desired explanation on at least the diagnosis, seriousness of illness, treatment and preventive steps. In gaining trust, patients expected that physicians would refrain from illegal or unethical activities related to patients, e.g., demanding money against free services, bringing patients in own private clinics by brokers (dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives. In terms of optimizing benefits: patients expected that physicians should be financially sensitive and consider individual need of patients. There were multiple dimensions of responsiveness- for some, stakeholders had a consensus; context was an important factor to understand them. This being an exploratory study, further research is recommended to validate the nuances of the findings. It can be a guideline for responsiveness practices, and a tipping point for future research

Future Science Prospects for AMI

The Arcminute Microkelvin Imager (AMI) is a telescope specifically designed for high sensitivity measurements of low-surface-brightness features at cm-wavelength and has unique, important capabilities. It consists of two interferometer arrays operating over 13.5-18 GHz that image structures on scales of 0.5-10 arcmin with very low systematics. The Small Array (AMI-SA; ten 3.7-m antennas) couples very well to Sunyaev-Zel'dovich features from galaxy clusters and to many Galactic features. The Large Array (AMI-LA; eight 13-m antennas) has a collecting area ten times that of the AMI-SA and longer baselines, crucially allowing the removal of the effects of confusing radio point sources from regions of low surface-brightness, extended emission. Moreover AMI provides fast, deep object surveying and allows monitoring of large numbers of objects. In this White Paper we review the new science - both Galactic and extragalactic - already achieved with AMI and outline the prospects for much more