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.

To address the health workforce deficit in underserved communities, the Federal Government of Nigeria is contemplating a licensing policy to delegate the provision of some basic health services to patent medicine vendors (PMVs) manned by a skilled health workforce. However, it remains unclear whether residents of underserved communities intend to receive these healthcare services through PMVs. We, therefore, sought to assess the intention to receive basic healthcare from PMVs among 665 heads of households from randomly selected 40 underserved communities in two northern Nigeria states. We used an interviewer-administered questionnaire to collect data between December 2021 and February 2022 for this cross-sectional study. The data were analyzed with STATA version 16. We used the Chi-square test to investigate the factors associated with ‘intention’ and Binary logistic regression to identify its predictors. The level of statistical significance was determined at P<0.05. We found that 38.8% of the underserved intend to receive basic health services through PMVs and that respondents who reside in rented buildings or temporary shelters and those who have a high level of trust in PPMVs had higher odds of intending to receive healthcare through PMVs. These findings suggest that PMVs can reach slightly above one-third of the underserved with healthcare. We recommend that healthcare administrators should consider designing additional complementary interventions that can be coherently implemented alongside this initiative to significantly improve healthcare access among the underserved. Keywords: Access, Communities, Healthcare, Intention, Workforce.