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Exploring Caregivers' Trust in Community Health Workers in Rural Uganda Open Access


Other title
community health workers
Type of item
Degree grantor
University of Alberta
Author or creator
Yue, Elizabeth
Supervisor and department
Saunders, Duncan (Public Health)
Alibhai, Arif (Public Health)
Examining committee member and department
Saunders, Duncan (Public Health)
Alibhai, Arif (Public Health)
Hawkes, Michael (Public Health)
Buregyeya, Esther (Public Health)
Kaler, Amy (Sociology)
School of Public Health
Global Health
Date accepted
Graduation date
2017-06:Spring 2017
Master of Science
Degree level
The purpose of this qualitative study is to gain a better understanding of the type of trust, and what factors influence the trust community members have in community health workers (CHWs) serving their communities in rural Western Uganda. Trust is a complex concept that has been widely recognized as important in patient-provider relationships, and has been found to positively influence health seeking behaviours as well as generate positive health outcomes. Trust within the health sector is a relatively new research area, with most of the current literature focused on relationships between patients and nurses or doctors in middle to high income countries. In developing countries, a large proportion of the population do not have access to nurses or doctors because of a shortage of skilled health workers. As a result, CHW programs have been developed to improve access to health services to rural and remote communities, where most of the population tend to live. CHWs are often the first point of contact with the health system for rural communities, but there is limited literature exploring the role or extent of trust in CHWs. Semi-structured interviews were conducted with caregivers of children under five years of age in Kyenjojo District, western Uganda to explore the type of trust and factors influencing their trust in CHWs providing medical services to children under five. Interviews were guided by a conceptual framework based on a model of trust in health providers in high resource settings. The findings indicate that some dimensions of trust identified in high resource medical relationships also apply in this low-resource context, such as perceived provider loyalty and competence. Authority figures reinforced perceived CHW competence and a strong emphasis was placed on interpersonal relationships and broader community-CHW interactions, such as reputation and word of mouth as important factors in the development of trust between caregivers and CHWs.
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