Trust in the Healthcare System and COVID-19 Treatment in the Developing World. Survey and Experimental Evidence from Armenia

Abstract

COVID-19 continues to spread across the globe at an exponential speed, infecting millions and overwhelming even the most prepared healthcare systems. Concerns are looming that the healthcare systems in low- and middle-income countries (LMICs) are mostly unprepared to combat the virus because of limited resources. The problems in LMICs are exacerbated by the fact that citizens in these countries generally exhibit low trust in the healthcare system, which could trigger a number of uncooperative behaviors. In this paper, we focus on one such behavior and investigate the relationship between trust in the healthcare system and the likelihood of potential treatment-seeking behavior upon the appearance of the first symptoms of COVID-19. First, we provide motivating evidence from a unique national on-line survey administered in Armenia — a post-Soviet LMIC country. We then present results from a large-scale survey experiment in Armenia that provides causal evidence in support of the investigated relationship. Our main finding is that a more trustworthy healthcare system enhances the likelihood of potential treatment-seeking behavior when observing the initial symptoms.