TY - JOUR
T1 - Community trust of government and non-governmental organizations during the 2014-16 Ebola epidemic in Liberia
AU - Arthur, Ronan F.
AU - Horng, Lily M.
AU - Bolay, Fatorma K.
AU - Tandanpolie, Amos
AU - Gilstad, John R.
AU - Tantum, Lucy K.
AU - Luby, Stephen P.
N1 - Funding Information:
RA received support from a NSF Graduate Research Fellowship (2015); LH, SL received support from a DOD Global Emerging Infections Surveillance grant (#P0244_15_N3; url: https://www.health.mil/Military-Health-Topics/ Combat-Support/Armed-Forces-Health-Surveillance-Branch/Global-Emerging-Infections-Surveillance-and-Response).We gratefully acknowledge scientific collaboration with the US Naval Medical Research Unit Three in Cairo, Egypt. Logistical support was provided by the Liberian Institute of Biomedical Research, the Armed Forces Liberia, and Q&A Services, Inc. We thank the study participants in each of our three study sites for their time and attention. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Navy, the Defense Health Agency, the Department of Defense, or the U.S. Government. This work was prepared as part of their official duties; and, as such, there is no copyright to be transferred.
Publisher Copyright:
© 2022, Public Library of Science. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - The West African Ebola Virus Disease epidemic of 2014-16 cost more than 11,000 lives. Interventions targeting key behaviors to curb transmission, such as safe funeral practices and reporting and isolating the ill, were initially unsuccessful in a climate of fear, mistrust, and denial. Building trust was eventually recognized as essential to epidemic response and prioritized, and trust was seen to improve toward the end of the epidemic as incidence fell. However, little is understood about how and why trust changed during Ebola, what factors were most influential to community trust, and how different institutions might have been per-ceived under different levels of exposure to the outbreak. In this large-N household survey conducted in Liberia in 2018, we measured self-reported trust over time retrospectively in three different communities with different exposures to Ebola. We found trust was consis-tently higher for non-governmental organizations than for the government of Liberia across all time periods. Trust reportedly decreased significantly from the start to the peak of the epidemic in the study site of highest Ebola incidence. This finding, in combination with a negative association found between knowing someone infected and trust of both iNGOs and the government, indicates the experience of Ebola may have itself caused a decline of trust in the community. These results suggest that national governments should aim to establish trust when engaging communities to change behavior during epidemics. Further research on the relationship between trust and epidemics may serve to improve epidemic response efficacy and behavior uptake.
AB - The West African Ebola Virus Disease epidemic of 2014-16 cost more than 11,000 lives. Interventions targeting key behaviors to curb transmission, such as safe funeral practices and reporting and isolating the ill, were initially unsuccessful in a climate of fear, mistrust, and denial. Building trust was eventually recognized as essential to epidemic response and prioritized, and trust was seen to improve toward the end of the epidemic as incidence fell. However, little is understood about how and why trust changed during Ebola, what factors were most influential to community trust, and how different institutions might have been per-ceived under different levels of exposure to the outbreak. In this large-N household survey conducted in Liberia in 2018, we measured self-reported trust over time retrospectively in three different communities with different exposures to Ebola. We found trust was consis-tently higher for non-governmental organizations than for the government of Liberia across all time periods. Trust reportedly decreased significantly from the start to the peak of the epidemic in the study site of highest Ebola incidence. This finding, in combination with a negative association found between knowing someone infected and trust of both iNGOs and the government, indicates the experience of Ebola may have itself caused a decline of trust in the community. These results suggest that national governments should aim to establish trust when engaging communities to change behavior during epidemics. Further research on the relationship between trust and epidemics may serve to improve epidemic response efficacy and behavior uptake.
UR - http://www.scopus.com/inward/record.url?scp=85124438021&partnerID=8YFLogxK
U2 - 10.1371/journal.pntd.0010083
DO - 10.1371/journal.pntd.0010083
M3 - Article
C2 - 35085236
AN - SCOPUS:85124438021
SN - 1935-2727
VL - 16
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 1
M1 - e0010083
ER -