Trust in the Bangladeshi health system during the COVID-19 pandemic: A mixed-methods exploration
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Abstract
Lack of trust in public health institutions hinders pandemic management. Our aim was to determine levels of impersonal and interpersonal trust in the context of coronavirus disease 2019 (COVID-19) pandemic response in Bangladesh. As this mixed-methods research was conducted during the pandemic, data was gathered via an online survey involving 508 respondents, along with seven online focus group discussions with 50 purposively selected participants. Survey respondents have less trust in the health system than in the service providers. The lowest level of trust was observed in the Fairness content area of trust. While some non-clinical participants blamed doctors for shying away from caregiving during the pandemic, most praised them for providing care, risking their lives, and even sacrificing their lives in the process. Several participants also cited a lack of fairness in pandemic management, such as visible attempts by the decision-makers to protect the business interests without consideration for the safety of the poor. However, both clinicians and non-clinicians concurred on the need for the service providers to improve communication related to COVID-19 management. Health sector stewards in Bangladesh should take a science-based, equity-focused pandemic response to gain both impersonal and interpersonal trust and build a resilient health system in the long run.
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