Trust as key to health sector reforms

Globally, the coronavirus disease (COVID-19) pandemic has sparked unexpected and violent outbursts against doctors, nurses, and other health personnel. In the Indian context, studies on violence against doctors and other medical staff largely focus on supply-demand imbalances in health care, overcrowding, drug shortages, negligence of critical care patients, lack of diagnostic and other essential devices (e.g., X-ray and ultrasound equipment and oxygen cylinders), deaths of patients, and bribery and corruption (collusion between doctors and pharmaceutical companies). While these factors explain such violence against medical personnel partly, we argue that it is largely rooted in a lack of trust in doctors and hospitals, which eroded rapidly during the COVID-19 pandemic. We analyze the covariates of trust in public and private health-care providers based on an all-India panel survey and delineate policies to rebuild trust, especially in public health care.