Pandemic Response and Public Trust: An Attitudinal Study of Patients and Attendants Towards Government Health Policies

Abstract

The COVID-19 pandemic not only brought to light the strengths and weaknesses of national health systems, but it also put the bond between citizens and the institutions tasked with safeguarding them under strain. Public trust is considered to be a factor in adherence with protective health behaviours, but there has been relatively limited research on the differences in attitudes towards government pandemic policy among the two primary groups of hospital users – patients and accompanying attendants. A cross sectional attitudinal study was conducted to explore the perception of the respondents on the clarity of communication, competence of the institutions, transparency of decisions, fairness of policies and allocation of resources among 420 respondents (230 patients and 190 attendants) who were selected from the Out Patient Department (OPD) and In Patient Department (IPD) of tertiary-care hospitals. A pre-validated structured questionnaire using the Likert scale was used and data collected were analysed using descriptive statistics, independent-samples t-tests, Pearson correlation, and chi-square test of association. In general, trust in government health policy was in the moderate range (M = 3.36, SD = 0.82 on 5-point scale), with the highest level of trust in perceived competence of health authorities (M = 3.72) and the lowest in adequacy of resource allocation (M = 2.99). Patients expressed slightly higher levels of trust than attendants on all five dimensions, and the difference was significant in the dimension of transparency of decision making (t = 2.43, p = 0.016). There was a strong and positive correlation between trust and satisfaction with health services (r = 0.78, p < 0.001), and a significant association between trust and self-reported compliance behaviour (χ² = 55.21, df = 2, p < 0.001). The main conclusions of this research are that open, regular, honest communication and even distribution of resources are key determinants of maintaining public trust during emergencies and that hospital attendants, a stakeholder group that may not be taken into account in risk communication campaigns, should be a focus in future.