Community engagement for stakeholder and community trust in healthcare: Short-term evaluation findings from a nationwide initiative in Lao PDR

Haenssgen, Marco J.; Elliott, Elizabeth M.; Phommachanh, Sysavanh; Souksavanh, Ounkham; Okabayashi, Hironori; Kubota, Shogo

doi:10.1016/j.socscimed.2024.117079

Social Science & Medicine

2024

DOI: 10.1016/j.socscimed.2024.117079

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Community engagement for stakeholder and community trust in healthcare: Short-term evaluation findings from a nationwide initiative in Lao PDR

Marco J. Haenssgen,

Elizabeth M. Elliott,

Sysavanh Phommachanh

et al.

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Cited by 2 publications

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Community engagement and local governance for health equity through trust: lessons from developing the CONNECT Initiative in the Lao People’s Democratic Republic

Kubota,

Elliott,

Ounaphom

et al. 2024

BMJ Glob Health

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Community engagement and local governance are important components of health interventions aiming to empower local populations. Yet, there is limited evidence on how to effectively engage with communities and codevelop interventions, especially in Southeast Asian contexts. Despite rapid progress, the Lao People’s Democratic Republic (Lao PDR) still has high maternal and child mortality, with essential service coverage showing significant disparities across socioeconomic strata. Long-standing challenges in community health were exacerbated by the COVID-19 pandemic and reinforced by poor trust between users and health providers. However, the pandemic also provided an opportunity to develop approaches for enhanced community engagement and local governance capacity to tackle health inequities. The Community Network Engagement for Essential Healthcare and COVID-19 Responses through Trust (CONNECT) Initiative, developed by the Lao PDR government, WHO and partners, has resulted in initial positive outcomes in community health such as increased vaccination uptake, facility births and trust in health providers. This case study describes the iterative, adaptive process by which the CONNECT Initiative was developed, and how the core components, key stakeholders, theory of change and evaluation framework evolved from grounded observations and hypotheses. Lessons learnt include (1) awareness of entry points and existing structures to strengthen local governance for health through mutually beneficial intersectoral collaboration; (2) building relationships and trust with an adaptive, grounds-up approach for sustainability and scalability. As a model which can be adapted to other settings, this case study provides evidence on how to engage with communities, strengthen local governance and codevelop interventions towards greater health equity.

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Community engagement and local governance for health equity through trust: lessons from developing the CONNECT Initiative in the Lao People’s Democratic Republic

Kubota,

Elliott,

Ounaphom

et al. 2024

BMJ Glob Health

View full text Add to dashboard Cite

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Building Trust and Trustworthiness in Public Institutions: Essential Elements in Placing Trust at the Heart of Health Policy and Systems Comment on "Placing Trust at the Heart of Health Policy and Systems"

Peters

2024

Int J Health Policy Manag

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In this commentary, I argue that societies are facing major crises in trust that extends well beyond health systems, outlining actions that can enhance trust in public institutions and benefit health systems. There are also areas where strengthening health systems can serve to build broader trust and social cohesion, such as by providing social protection and health services that are responsive to people’s needs. Understanding the dimensions of "trustworthiness" for different actors in a health system also provide insights on how to build, restore, and maintain trust. Whereas research evidence claims a foundational role for trustworthy intervention among health professions, other factors may be more influential for others. These include the credibility of the source, participation in the intervention with observably fair distribution of the benefits, the ethical behavior of key actors, reliability in service delivery and its results, transparent and consistent communications, and addressing breaches in trust.

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Community engagement for stakeholder and community trust in healthcare: Short-term evaluation findings from a nationwide initiative in Lao PDR

Cited by 2 publications

References 38 publications

Community engagement and local governance for health equity through trust: lessons from developing the CONNECT Initiative in the Lao People’s Democratic Republic

Community engagement and local governance for health equity through trust: lessons from developing the CONNECT Initiative in the Lao People’s Democratic Republic

Building Trust and Trustworthiness in Public Institutions: Essential Elements in Placing Trust at the Heart of Health Policy and Systems Comment on "Placing Trust at the Heart of Health Policy and Systems"

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