An Assessment of Healthcare Relationship Trust between Patent Medicine Vendors and Residents of Hard-to-Reach Settlements in Northern Nigeria

Abstract

A trusting relationship is required for effective communication between care providers and care seekers, and trust is a determinant of early healthcare-seeking and care outcomes. The patient-Doctor healthcare trust relationship has been widely studied in different settings. However, there is a dearth of information on whether the factors underlying healthcare relationship trust between patients and their doctors are the same as those underlying patients’ trust in other healthcare professionals (including the PPMVs). This study, therefore, aims to assess the level and determinants of healthcare relationship trust between patent medicine vendors and their clients in hard-to-reach settlements in North-western Nigeria. We adapted the revised healthcare relationship trust scale, administered by trained data collectors using android devices. The data were analysed using Stata (version 16). We used the Chi-square test to identify the correlates of the level of trust(high/low), and binary logistic regression was used to identify its determinants. Statistical significance was defined as P<0.05. Slightly above one-quarter (28.1%) of the underserved had high healthcare relationship trust in the PPMVs. Being married, male, residing in a rented or makeshift shelter in Kaduna state, with under-five child(ren) in their household, and self-reporting good health predicted a high level of healthcare relationship trust in PPMVs among the underserved who participated in this study. We concluded that the personal and household characteristics of the underserved could significantly influence their level of trust in PPMV. Therefore, to achieve the aim of improving health outcomes in deprived populations, initiatives seeking to integrate PPMVs into the formal health system in resource-constrained settings should seek to address the determinants of healthcare relationship trust in these populations as part of their rollout process. Keywords: Communities, Hard-to-reach, Healthcare, Trust, Relationship, Workforce.