Citizens trust in public institution: A studyof service delivery institutions at local level in Bangladesh

Abstract

Trust is perceived as a vital element in social relationships and it occupies a central place in every human transaction. Trust is equally important in individual as well as organizational level for demonstration of desired commitment and also to safeguard parties from malfeasance. Trust has multiple meanings and definitions and an integrated approach to understanding trust still remains elusive. It is considered as an important variable in explaining public and political institutions for its claim for legitimacy and also from growing credence from the perspective of good governance. It explains how relations between and among actors and in institutions are initiated, developed and sustained. The study on citizens’ trust in public institution maps and analyzes patients’ trust on Upazila Health Complex (UHC) - a public hospital poised for delivering primary health care at the upazila (sub-district) level in rural Bangladesh. The study also explores factors based on which patients’ trust at UHC may be built and sustained. By adopting a cross sectional design, the survey was conducted in 6 upazilas of five districts within the territorial jurisdiction of three divisions of Bangladesh. The study employs a mixed approach combining both quantitative and qualitative methods to map patients’ trust perception on doctors at UHC. The study attempts to answer three broad research questions. First, What is the state of generalized trust among the users of primary health services at upazila?, Second, identify the major trust arenas and potential sources of opportunism at UHC, and third, identify the factors which may contribute to trust formation for UHC and how it may affect service delivery?