Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey

Summary: Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey—a novel population survey conducted in 15 low-income, middle-income, and high-income countries—we report health system confidence among the general population and analyse i...

Full description

Bibliographic Details
Main Authors: Margaret E Kruk, ProfMD, Neena R Kapoor, MSc, Todd P Lewis, PhD, Catherine Arsenault, PhD, Eleni C Boutsikari, MSc, João Breda, PhD, Susanne Carai, MD, Kevin Croke, PhD, Rashmi Dayalu, MPH, Günther Fink, PhD, Patricia J Garcia, Munir Kassa, MD, Sailesh Mohan, MD, Mosa Moshabela, MBChB PhD, Jacinta Nzinga, PhD, Juhwan Oh, MD PhD, Emelda A Okiro, PhD, Dorairaj Prabhakaran, MD MSc, Gillian K SteelFisher, PhD, Rosanna Tarricone, PhD, Ezequiel Garcia-Elorrio, MD PhD
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:The Lancet Global Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2214109X23004990
_version_ 1827584874593124352
author Margaret E Kruk, ProfMD
Neena R Kapoor, MSc
Todd P Lewis, PhD
Catherine Arsenault, PhD
Eleni C Boutsikari, MSc
João Breda, PhD
Susanne Carai, MD
Kevin Croke, PhD
Rashmi Dayalu, MPH
Günther Fink, PhD
Patricia J Garcia
Munir Kassa, MD
Sailesh Mohan, MD
Mosa Moshabela, MBChB PhD
Jacinta Nzinga, PhD
Juhwan Oh, MD PhD
Emelda A Okiro, PhD
Dorairaj Prabhakaran, MD MSc
Gillian K SteelFisher, PhD
Rosanna Tarricone, PhD
Ezequiel Garcia-Elorrio, MD PhD
author_facet Margaret E Kruk, ProfMD
Neena R Kapoor, MSc
Todd P Lewis, PhD
Catherine Arsenault, PhD
Eleni C Boutsikari, MSc
João Breda, PhD
Susanne Carai, MD
Kevin Croke, PhD
Rashmi Dayalu, MPH
Günther Fink, PhD
Patricia J Garcia
Munir Kassa, MD
Sailesh Mohan, MD
Mosa Moshabela, MBChB PhD
Jacinta Nzinga, PhD
Juhwan Oh, MD PhD
Emelda A Okiro, PhD
Dorairaj Prabhakaran, MD MSc
Gillian K SteelFisher, PhD
Rosanna Tarricone, PhD
Ezequiel Garcia-Elorrio, MD PhD
author_sort Margaret E Kruk, ProfMD
collection DOAJ
description Summary: Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey—a novel population survey conducted in 15 low-income, middle-income, and high-income countries—we report health system confidence among the general population and analyse its associated factors. Across the 15 countries, fewer than half of respondents were health secure and reported being somewhat or very confident that they could get and afford good-quality care if very sick. Only a quarter of respondents endorsed their current health system, deeming it to work well with no need for major reform. The lowest support was in Peru, the UK, and Greece—countries experiencing substantial health system challenges. Wealthy, more educated, young, and female respondents were less likely to endorse the health system in many countries, portending future challenges for maintaining social solidarity for publicly financed health systems. In pooled analyses, the perceived quality of the public health system and government responsiveness to public input were strongly associated with all confidence measures. These results provide a post-COVID-19 pandemic baseline of public confidence in the health system. The survey should be repeated regularly to inform policy and improve health system accountability.
first_indexed 2024-03-08T23:37:35Z
format Article
id doaj.art-4041867a3a75484aa647b7cf41a01e4a
institution Directory Open Access Journal
issn 2214-109X
language English
last_indexed 2024-03-08T23:37:35Z
publishDate 2024-01-01
publisher Elsevier
record_format Article
series The Lancet Global Health
spelling doaj.art-4041867a3a75484aa647b7cf41a01e4a2023-12-14T05:22:50ZengElsevierThe Lancet Global Health2214-109X2024-01-01121e100e111Population confidence in the health system in 15 countries: results from the first round of the People's Voice SurveyMargaret E Kruk, ProfMD0Neena R Kapoor, MSc1Todd P Lewis, PhD2Catherine Arsenault, PhD3Eleni C Boutsikari, MSc4João Breda, PhD5Susanne Carai, MD6Kevin Croke, PhD7Rashmi Dayalu, MPH8Günther Fink, PhD9Patricia J Garcia10Munir Kassa, MD11Sailesh Mohan, MD12Mosa Moshabela, MBChB PhD13Jacinta Nzinga, PhD14Juhwan Oh, MD PhD15Emelda A Okiro, PhD16Dorairaj Prabhakaran, MD MSc17Gillian K SteelFisher, PhD18Rosanna Tarricone, PhD19Ezequiel Garcia-Elorrio, MD PhD20Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA; Correspondence to: Prof Margaret E Kruk, Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA 02115, USADepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USADepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USADepartment of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, USADivision of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, GreeceDivision of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, GreeceDivision of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, GreeceDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USADepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USADepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, SwitzerlandDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USAMinister's Office, Ministry of Health, Addis Ababa, EthiopiaPublic Health Foundation of India, New Delhi, IndiaCollege of Health Sciences, University of KwaZulu–Natal, Durban, South AfricaHealth Economics Research Unit, KEMRI–Wellcome Trust Research Programme, Nairobi, KenyaSeoul National University College of Medicine, Seoul, South KoreaPopulation and Health Impact Surveillance Group, KEMRI–Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UKPublic Health Foundation of India, New Delhi, IndiaDepartment of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USADepartment of Social and Political Science, Bocconi University, Milan, ItalySchool of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru; Health Care Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, ArgentinaSummary: Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey—a novel population survey conducted in 15 low-income, middle-income, and high-income countries—we report health system confidence among the general population and analyse its associated factors. Across the 15 countries, fewer than half of respondents were health secure and reported being somewhat or very confident that they could get and afford good-quality care if very sick. Only a quarter of respondents endorsed their current health system, deeming it to work well with no need for major reform. The lowest support was in Peru, the UK, and Greece—countries experiencing substantial health system challenges. Wealthy, more educated, young, and female respondents were less likely to endorse the health system in many countries, portending future challenges for maintaining social solidarity for publicly financed health systems. In pooled analyses, the perceived quality of the public health system and government responsiveness to public input were strongly associated with all confidence measures. These results provide a post-COVID-19 pandemic baseline of public confidence in the health system. The survey should be repeated regularly to inform policy and improve health system accountability.http://www.sciencedirect.com/science/article/pii/S2214109X23004990
spellingShingle Margaret E Kruk, ProfMD
Neena R Kapoor, MSc
Todd P Lewis, PhD
Catherine Arsenault, PhD
Eleni C Boutsikari, MSc
João Breda, PhD
Susanne Carai, MD
Kevin Croke, PhD
Rashmi Dayalu, MPH
Günther Fink, PhD
Patricia J Garcia
Munir Kassa, MD
Sailesh Mohan, MD
Mosa Moshabela, MBChB PhD
Jacinta Nzinga, PhD
Juhwan Oh, MD PhD
Emelda A Okiro, PhD
Dorairaj Prabhakaran, MD MSc
Gillian K SteelFisher, PhD
Rosanna Tarricone, PhD
Ezequiel Garcia-Elorrio, MD PhD
Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
The Lancet Global Health
title Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
title_full Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
title_fullStr Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
title_full_unstemmed Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
title_short Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey
title_sort population confidence in the health system in 15 countries results from the first round of the people s voice survey
url http://www.sciencedirect.com/science/article/pii/S2214109X23004990
work_keys_str_mv AT margaretekrukprofmd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT neenarkapoormsc populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT toddplewisphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT catherinearsenaultphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT elenicboutsikarimsc populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT joaobredaphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT susannecaraimd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT kevincrokephd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT rashmidayalumph populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT guntherfinkphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT patriciajgarcia populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT munirkassamd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT saileshmohanmd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT mosamoshabelambchbphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT jacintanzingaphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT juhwanohmdphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT emeldaaokirophd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT dorairajprabhakaranmdmsc populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT gillianksteelfisherphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT rosannatarriconephd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey
AT ezequielgarciaelorriomdphd populationconfidenceinthehealthsystemin15countriesresultsfromthefirstroundofthepeoplesvoicesurvey