Exploring Meaning and Types of Trust in Maternity Care in Peri-Urban Kenya: A Qualitative Cross-Perspective Analysis

Qual Health Res. 2018 Jan;28(2):305-320. doi: 10.1177/1049732317723585. Epub 2017 Aug 18.

Abstract

Trust offers a distinctive lens on facility responsiveness during labor and birth. Though acknowledged in prior literature, limited work exists linking conceptual and empirical spheres. This study explores trust in the maternity setting in Kenya through a theoretically driven qualitative approach. Focus groups ( n = 8, N = 70) with women who recently gave birth (WRB), pregnant women, and male partners, and in-depth-interviews ( n = 33) with WRB, frontline providers, and management, were conducted in and around a peri-urban public hospital. Combined coding and memo-writing showed that trust in maternity care is nested within understandings of institutional and societal trust. Content areas of trust include confidence, communication, integrity, mutual respect, competence, fairness, confidentiality, and systems trust. Trust is relevant, multidimensional, and dynamic. Examining trust provides a basis for developing quantitative measures and reveals structural underpinnings, repercussions for trust in other health areas, and health systems inequities, which have implications for maternal health policy, programming, and service utilization.

Keywords: childbirth; health seeking; maternity; qualitative; qualitative methods; sub-Saharan; trust; users’ experiences.

MeSH terms

  • Adolescent
  • Adult
  • Clinical Competence
  • Communication*
  • Confidentiality
  • Female
  • Humans
  • Interviews as Topic
  • Kenya
  • Male
  • Maternal Health Services / organization & administration*
  • Patient Satisfaction*
  • Pregnancy
  • Qualitative Research
  • Trust*
  • Young Adult