scholarly journals Public Trust in Healthcare System in Iran: A Rapid Assessment During the COVID-19 Epidemic in Iran

2021 ◽  
Vol 8 (4) ◽  
pp. 146-151
Author(s):  
Kamran Bagheri-Lankarani ◽  
Mohammad-Hadi Imanieh ◽  
Amir-Hossein Hassani ◽  
Hossein Molavi Vardanjani

Background and aims: Public health policies and programs should be adapted to the level of public trust in the healthcare system, as an indicator of the public support level. Accordingly, the data about public trust level in the healthcare system is considered as a critical requirement for managing public health crises. This study aimed to rapidly assess the public trust in the healthcare system during the COVID-19 epidemic in Iran, as well as to evaluate the effect of socioeconomic status (SES) on this trust. Methods: This cross-sectional and web-based study which was conducted in Iran during the COVID-19 epidemic included adults aged 18-60 years. A probability proportional to size multistage random sampling was applied and performed in 15 provinces of the country. Data on the main sources of information about COVID-19, trust in healthcare system, fear level of COVID-19, and demographics were collected via an electronic questionnaire. Multiple linear regression was applied, and adjusted regression coefficients and 95% confidence intervals (CIs) were estimated. Results: A total of 5250 adults (response rate: 76%) were included in the study. The mean of reported trust scores was 50.3±22.8, and that of fear scores was 72.0±17.8. The highest (65%) and lowest (28%) levels of trust were observed among participants from the lowest and highest SES, respectively. Gender (male) (P=0.006), higher levels of education (P<0.001), higher socio-economic status (P<0.001), and higher fear scores (P<0.001) were independently correlated with the lower level of ⦰ trust in healthcare system. Conclusion: It was found that the public trust in Iran’s healthcare system was not high enough at the time of the COVID-19 epidemic in the country, especially among higher social class population.

2020 ◽  
Author(s):  
Hossein Molavi Vardanjani ◽  
Mohammad-Hadi Imanieh ◽  
Amir-Hossein Hassani ◽  
Kamran Bagheri-Lankarani

Abstract Background: Public trust in the healthcare system is a critical necessity of management in public health crises such as the COVID-19 pandemic. To rapidly assess the public trust in the healthcare system during the COVID-19 epidemic and its correlates in Iran.Methods: A cross-sectional rapid assessment was conducted in Iran during the COVID-19 epidemic in the country. A probability proportional to size multistage random sampling was applied. Sampling was done in 15 provinces. We collected data on public perceived fear, public trust in health system and socio-demographics. Ordinary least square regression modeling was applied to identify correlates of public trust.Results: A total of 5250 adults (response rate: 76%) were participated in the study. Mean of reported trust scores was 50.3±22.8, and of fear scores was 72.0±17.8. Being male (p=0.006), higher levels of education (p<0.001) and socio-economic status (p<0.001), and higher fear scores (p<0.001) were independently correlated with trust in healthcare system. Conclusion: At the time of the COVID-19 epidemic in Iran, public trust in healthcare system is low. A dynamic public epidemic communication with appropriate strategies to communicate with higher social classes is urgent in Iran. Rapid assessments to identify appropriate strategies are needed. These results might be generalizable to the other similar countries during the COVID-19 pandemic.


2020 ◽  
Author(s):  
Tamam El-Elimat ◽  
Mahmoud M. AbuAlSamen ◽  
Basima A. Almomani ◽  
Nour A. Al-Sawalha ◽  
Feras Q. Alali

AbstractBackgroundVaccines are effective interventions that can reduce the high burden of diseases globally. However, public vaccine hesitancy is a pressing problem for public health authorities. With the availability of COVID-19 vaccines, little information is available on the public acceptability and attitudes towards the COVID-19 vaccines in Jordan. This study aimed to investigate the acceptability of COVID-19 vaccines and its predictors in addition to the attitudes towards these vaccines among public in Jordan.MethodsAn online, cross-sectional, and self-administered questionnaire was instrumentalized to survey adult participants from Jordan on the acceptability of COVID-19 vaccines. Logistic regression analysis was used to find the predictors of COVID-19 vaccines’ acceptability.ResultsA total of 3,100 participants completed the survey. The public acceptability of COVID-19 vaccines was fairly low (37.4%) in Jordan. Males (OR=2.488, 95CI%=1.834–3.375, p<.001) and those who took the seasonal influenza vaccine (OR=2.036, 95CI%=1.306–3.174, p=.002) were more likely to accept Covid-19 vaccines. Similarly, participants who believed that vaccines are generally safe (OR=9.258, 95CI%=6.020–14.237, p<.001) and those who were willing to pay for vaccines (OR=19.223, 95CI%=13.665–27.042, p<.001), once available, were more likely to accept the COVID-19 vaccines. However, those above 35 years old (OR=0.376, 95CI%=0.233-0.607, p<.001) and employed participants (OR=0.542, 95CI%=0.405-0.725, p<.001) were less likely to accept the COVID-19 vaccines. Moreover, participants who believed that there was a conspiracy behind COVID-19 (OR=0.502, 95CI%=0.356- 0.709, p<.001) and those who do not trust any source of information on COVID-19 vaccines (OR=0.271, 95CI%=0.183 – 0.400, p<.001), were less likely to have acceptance towards them. The most trusted sources of information on COVID-19 vaccines were healthcare providers.ConclusionSystematic interventions are required by public health authorities to reduce the levels of vaccines’ hesitancy and improve their acceptance. We believe these results and specifically the low rate of acceptability is alarming to Jordanian health authorities and should stir further studies on the root causes and the need of awareness campaigns. These interventions should take the form of reviving the trust in national health authorities and structured awareness campaigns that offer transparent information about the safety and efficacy of the vaccines and the technology that was utilized in their production.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250555
Author(s):  
Tamam El-Elimat ◽  
Mahmoud M. AbuAlSamen ◽  
Basima A. Almomani ◽  
Nour A. Al-Sawalha ◽  
Feras Q. Alali

Vaccines are effective interventions that can reduce the high burden of diseases globally. However, public vaccine hesitancy is a pressing problem for public health authorities. With the availability of COVID-19 vaccines, little information is available on the public acceptability and attitudes towards the COVID-19 vaccines in Jordan. This study aimed to investigate the acceptability of COVID-19 vaccines and its predictors in addition to the attitudes towards these vaccines among public in Jordan. An online, cross-sectional, and self-administered questionnaire was instrumentalized to survey adult participants from Jordan on the acceptability of COVID-19 vaccines. Logistic regression analysis was used to find the predictors of COVID-19 vaccines’ acceptability. A total of 3,100 participants completed the survey. The public acceptability of COVID-19 vaccines was fairly low (37.4%) in Jordan. Males (OR = 2.488, 95CI% = 1.834–3.375, p < .001) and those who took the seasonal influenza vaccine (OR = 2.036, 95CI% = 1.306–3.174, p = .002) were more likely to accept COVID-19 vaccines. Similarly, participants who believed that vaccines are generally safe (OR = 9.258, 95CI% = 6.020–14.237, p < .001) and those who were willing to pay for vaccines (OR = 19.223, 95CI% = 13.665–27.042, p < .001), once available, were more likely to accept the COVID-19 vaccines. However, those above 35 years old (OR = 0.376, 95CI% = 0.233–0.607, p < .001) and employed participants (OR = 0.542, 95CI% = 0.405–0.725, p < .001) were less likely to accept the COVID-19 vaccines. Moreover, participants who believed that there was a conspiracy behind COVID-19 (OR = 0.502, 95CI% = 0.356–0.709, p < .001) and those who do not trust any source of information on COVID-19 vaccines (OR = 0.271, 95CI% = 0.183–0.400, p < .001), were less likely to have acceptance towards them. The most trusted sources of information on COVID-19 vaccines were healthcare providers. Systematic interventions are required by public health authorities to reduce the levels of vaccines’ hesitancy and improve their acceptance. We believe these results and specifically the low rate of acceptability is alarming to Jordanian health authorities and should stir further studies on the root causes and the need of awareness campaigns. These interventions should take the form of reviving the trust in national health authorities and structured awareness campaigns that offer transparent information about the safety and efficacy of the vaccines and the technology that was utilized in their production.


2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Meagan Marie Daoust

The healthcare trend of parental refusal or delay of childhood vaccinations will be investigated through a complex Cynefin Framework component in an economic and educational context, allowing patterns to emerge that suggest recommendations of change for the RN role and healthcare system. As a major contributing factor adding complexity to this trend, social media is heavily used for health related knowledge, making it is difficult to determine which information is most trustworthy. Missed opportunities for immunization can result, leading to economic and health consequences for the healthcare system and population. Through analysis of the powerful impact social media has on this evolving trend and public health, an upstream recommendation for RNs to respond with is to utilize reliable social media to the parents’ advantage within practice. The healthcare system should focus on incorporating vaccine-related education into existing programs and classes offered to parents, and implementing new vaccine classes for the public.


Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 199
Author(s):  
Myeong Sook Yoon ◽  
Israel Fisseha Feyissa ◽  
So-Won Suk

In the COVID-19 pandemic, marginalized groups like migrants are disproportionately affected. As panic, fear of neglect, and mistrusting institutions in these groups are presumed to be apparent, their detachment to health services still needs to be investigated. This study comparatively analyzed the level of panic and trust between South Koreans and immigrants who are living within highly affected areas of South Korea. Mann–Whitney-U-Test and Pearson correlation showed panic is more pronounced in the Korean group while having a similar panic display pattern with the immigrants. The immigrant group appears to highly trust the Korean health system, health institutions, local media, and the local native community. Beyond conventional expectations, participant’s average panic score showed a statistically significant positive correlation with items of the trust scale, indicating a level of individual reliance amid the pandemic panic. Thus, ascertaining institutional trust and matured citizenry are identified as factors for effective public health outcomes. During such a pandemic, this study also reminded the public health needs of immigrants as secondary citizens, and presumptions of immigrants’ mistrust in such settings might not always be true.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043421
Author(s):  
Rae Thomas ◽  
Hannah Greenwood ◽  
Zoe A Michaleff ◽  
Eman Abukmail ◽  
Tammy C Hoffmann ◽  
...  

ObjectivePublic cooperation to practise preventive health behaviours is essential to manage the transmission of infectious diseases such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission and prevention that have the potential to impact the uptake of recommended public health strategies.DesignAn online cross-sectional survey.ParticipantsA national sample of 1500 Australian adults with representative quotas for age and gender provided by an online panel provider.Main outcome measureProportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions.ResultsOf the 1802 potential participants contacted, 289 did not qualify, 13 declined and 1500 participated in the survey (response rate 83%). Most participants correctly identified ‘washing your hands regularly with soap and water’ (92%) and ‘staying at least 1.5 m away from others’ (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them from contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that ‘regular use of antibiotics’ would not prevent COVID-19.Most participants (90%) identified ‘fever, fatigue and cough’ as indicators of COVID-19. However, 42% of participants thought that being unable to ‘hold your breath for 10 s without coughing’ was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%) and the Australian Government COVID-19 information app (31%).ConclusionsPublic messaging about hand hygiene and physical distancing to prevent transmission appears to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long term. We need to develop public health messages that harness these barriers to improve future cooperation. Ensuring adherence to these interventions is critical.


2018 ◽  
Vol 21 (18) ◽  
pp. 3407-3421 ◽  
Author(s):  
Melissa Mialon ◽  
Jonathan Mialon

AbstractObjectiveTo identify the corporate political activity (CPA) of major food industry actors in France.DesignWe followed an approach based on information available in the public domain. Different sources of information, freely accessible to the public, were monitored.Setting/SubjectsData were collected and analysed between March and August 2015. Five actors were selected: ANIA (Association Nationale des Industries Agroalimentaires/National Association of Agribusiness Industries); Coca-Cola; McDonald’s; Nestlé; and Carrefour.ResultsOur analysis shows that the main practices used by Coca-Cola and McDonald’s were the framing of diet and public health issues in ways favourable to the company, and their involvement in the community. ANIA primarily used the ‘information and messaging’ strategy (e.g. by promoting deregulation and shaping the evidence base on diet- and public health-related issues), as well as the ‘policy substitution’ strategy. Nestlé framed diet and public health issues, and shaped the evidence base on diet- and public health-related issues. Carrefour particularly sought involvement in the community.ConclusionsWe found that, in 2015, the food industry in France was using CPA practices that were also used by other industries in the past, such as the tobacco and alcohol industries. Because most, if not all, of these practices proved detrimental to public health when used by the tobacco industry, we propose that the precautionary principle should guide decisions when engaging or interacting with the food industry.


Author(s):  
Clea Adas Saliba Garbin ◽  
Bruno Wakayama ◽  
Tânia Adas Saliba ◽  
Orlando Adas Saliba Junior ◽  
Artênio José Ísper Garbin

2021 ◽  
Vol 9 ◽  
Author(s):  
Dongjin Chen ◽  
Qian Zhou ◽  
Cornelius B. Pratt ◽  
Zhenhua Su ◽  
Zheng Gu

Objective: Public trust in physicians and public health literacy (HL) are important factors that ensure the effectiveness of health-care delivery, particularly that provided during the SARS-CoV-2 pandemic. This study investigates HL as a predictor of public trust in physicians in China's ongoing efforts to control COVID-19.Methods: Data were gathered in February 2020 during the peak of the disease in China. Based on Nutbeam's conceptualization of HL, we measure HL vis-à-vis COVID-19 by using a six-item scale that includes two items each for functional, interactive, and critical HL. Trust in physicians was measured by assessing physicians' capability to diagnose COVID-19. A rank-sum test and ordinal logit regression modeling were used to analyze the data.Results: Two key findings: (a) trust in physician handling of treatment for COVID-19 is reported by about 74% of respondents; and (b) five of the six HL measures are positive predictors of public trust in physician treatment of the disease, with functional HL1 having the highest level of such association (coefficient 0.285, odds ratio 1.33%, p &lt; 0.01).Conclusions: Improving public HL is important for better public-physician relationships, as well as for nations' efforts to contain the pandemic, serving as a possible behavioral, non-clinical antidote to COVID-19. Being confronted with the unprecedented virus, humans need trust. Health education and risk communication can improve public compliance with physicians' requirements and build a solid foundation for collective responses.


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