ArticleSocial science & medicine (1982)2021
The role of trust in health-seeking for non-communicable disease services in fragile contexts: A cross-country comparative study.
Article in Social science & medicine (1982), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Why do people trust (or mistrust) health organizations? A systematic review.International journal for equity in health · 2026Pooled it
- A systematic review and meta-analysis of the effectiveness of hypertension interventions in faith-based organisation settings.Journal of global health · 2023Pooled it
- How do limited familial ties and community relationships shape health-seeking in older adulthood? Evidence from Indonesia.The journals of gerontology. Series B, Psychological sciences and social sciences · 2026Article
- Social Trust Profile Transitions and Health-Seeking Behavior: A Latent Transition Analysis of Three-Wave Panel Data from China.Behavioral sciences (Basel, Switzerland) · 2026Article
- "Paint and Sip for Cancer Prevention": A Novel Arts-Based Community Engagement Strategy to Advance Cancer Education and Screening in Underserved Individuals.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Article
- Perceived enjoyment from virtual experience to real-world care: how Chinese digital games containing TCM culture influence players' TCM treatment intention.Frontiers in public health · 2026Article
- Public confidence in Ireland's Health Service Executive, Mid-West region: Findings from a 2024 regional survey.BMC health services research · 2025Article
- Use of traditional medicine for hypertension, diabetes and hypercholesterolaemia measured in 71 surveys.Bulletin of the World Health Organization · 2025Article
- When conflict meets political exclusion: Ethnicity, governance, and child mortality.SSM - population health · 2025Article
- Decentralising healthcare for diabetes and hypertension from secondary to primary level in a humanitarian setting in Kurdistan, Iraq: a qualitative study.BMC health services research · 2025Article
- What influences the people's trust on public healthcare system in Bihar, India? A mixed methods study.BMC health services research · 2025Article
- Contextualising person-centred mental health and psychosocial support (MHPSS) services: A qualitative study of the preferences and experiences of displaced Syrians in Northwest Syria and Türkiye.Global mental health (Cambridge, England) · 2025Article
- Trust in family doctor-patient relations: an embeddedness theory perspective.BMC public health · 2024Article
- Trust in institutions affects vaccination campaign outcomes.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2024Article
- Capturing sources of health system legitimacy in fragmented conflict zones under different governance models: a case study of northwest Syria.Globalization and health · 2024Article
- Providing continuity of care for people living with noncommunicable diseases in humanitarian settings: A qualitative study of health actors' experiences in Lebanon.Journal of migration and health · 2024Article
- Barriers to access to cancer care for patients from the conflict-affected region of the Nagorno-Karabakh Republic: A qualitative study.PLOS global public health · 2024Article
- Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey.The Lancet. Global health · 2024Review
- Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone.BMC public health · 2023Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
Non-communicable diseases (NCDs) disproportionately affect people living in fragile contexts marked by poor governance and health systems struggling to deliver quality services for the benefit of all. This combination can lead to the erosion of trust in the health system, affecting health-seeking behaviours and the ability of individuals to sustain their health. In this cross-country multiple-case study, we analyse the role of trust in health-seeking for NCD services in fragile contexts. Our analysis triangulates multiple data sources, including semi-structured interviews (n = 102) and Group Model Building workshops (n = 8) with individuals affected by NCDs and health providers delivering NCD services. Data were collected in Freetown and Makeni (Sierra Leone), Beirut and Beqaa (Lebanon), and Morazán, Chalatenango and Bajo Lempa (El Salvador) between April 2018 and April 2019. We present a conceptual model depicting key dynamics and feedback loops between contextual factors, institutional, interpersonal and social trust and health-seeking pathways. Our findings signal that firstly, the way health services are delivered and experienced shapes institutional trust in health systems, interpersonal trust in health providers and future health-seeking pathways. Secondly, historical narratives about public institutions and state authorities' responses to contextual fragility drivers impact institutional trust and utilisation of services from public health institutions. Thirdly, social trust mediates health-seeking behaviour through social bonds and links between health systems and individuals affected by NCDs. Given the repeated and sustained utilisation of health services required with these chronic diseases, (re)building and maintaining trust in public health institutions and providers is a crucial task in fragile contexts. This requires interventions at community, district and national levels, with a key focus on promoting links and mutual accountability between health systems and communities affected by NCDs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.