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Challenges, Distrust, and Understanding: Employing Communicative Action in Improving Trust in a Public Medical Sector in Uganda

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  • Grace Akello
  • Ulrike Beisel

Abstract

We assessed how the everyday work challenges that frontline health workers (FRHWs) face in the government health sector in northern Uganda influence their trust in the Ministry of Health (MOH). We employed qualitative research techniques, including interviews and participant observation, over a 9-month period to examine FRHWs’ viewpoints about how the MOH should address these challenges in service delivery. One hundred and sixty-five FRHWs, of whom 48 were recruited for extensive follow-up, participated in our study. Key findings include distrust in the MOH is prevalent among FRHWs, there is a lack of trust in the organization’s coordination role in service delivery and this affects health care delivery to patients, interrelations, and provider cooperation. Therefore, restoring trust in government hospitals will require a truthful non-violent response by the MOH in its contractual agreement with FRHWs. In our analysis, we employ Habermas’s Theory of Communicative Action.

Suggested Citation

  • Grace Akello & Ulrike Beisel, 2019. "Challenges, Distrust, and Understanding: Employing Communicative Action in Improving Trust in a Public Medical Sector in Uganda," SAGE Open, , vol. 9(4), pages 21582440198, December.
    • Handle: RePEc:sae:sagope:v:9:y:2019:i:4:p:2158244019893705
    DOI: 10.1177/2158244019893705
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    1. van der Geest, Sjaak & Finkler, Kaja, 2004. "Hospital ethnography: introduction," Social Science & Medicine, Elsevier, vol. 59(10), pages 1995-2001, November.
    2. Wolffers, Ivan, 1995. "The role of pharmaceuticals in the privatization process in Vietnam's health-care system," Social Science & Medicine, Elsevier, vol. 41(9), pages 1325-1332, November.
    3. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    4. Akello, Grace & Reis, Ria & Richters, Annemiek, 2010. "Silencing distressed children in the context of war in northern Uganda: An analysis of its dynamics and its health consequences," Social Science & Medicine, Elsevier, vol. 71(2), pages 213-220, July.
    5. Birungi, Harriet, 1998. "Injections and self-help: risk and trust in Ugandan health care," Social Science & Medicine, Elsevier, vol. 47(10), pages 1455-1462, November.
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    1. Leach, Melissa & MacGregor, Hayley & Akello, Grace & Babawo, Lawrence & Baluku, Moses & Desclaux, Alice & Grant, Catherine & Kamara, Foday & Nyakoi, Marion & Parker, Melissa & Richards, Paul & Mokuwa,, 2022. "Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era," Social Science & Medicine, Elsevier, vol. 298(C).

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