No 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.