| Issue/Objective |
Against the backdrop of nearly three decades of conflict (1996-2025), Eastern DRC has faced multiple Ebola outbreaks that severely eroded community trust in health systems. This research examines how trust-rebuilding mechanisms evolved in a setting where conflict dynamics complicated outbreak responses, and explores the relationship between trust recovery and health system resilience in crisis-affected settings. |
| Methodology/Approach |
This mixed-methods study combined retrospective analysis of trust-building interventions during Ebola responses (2018-2023) with longitudinal community surveys across 14 health zones in North Kivu. We conducted 87 semi-structured interviews with health workers, community leaders, and Ebola survivors, complemented by participatory ethnographic research documenting indigenous trust-recovery approaches that emerged outside formal response mechanisms. |
| Results |
We identified three critical yet often overlooked trust-rebuilding mechanisms: 1) Integration of traditional authorities into health governance structures, increasing treatment acceptance by 63%; 2) Transparent accountability processes for resource allocation, reducing community resistance incidents by 74%; and 3) Culturally-adapted risk communication, decreasing misinformation spread by 59%. Trust recovery trajectories varied significantly between communities based on conflict exposure and pre-existing governance structures. |
| Discussion/Conclusion |
This research reveals that effective trust rebuilding does not simply restore pre-crisis conditions but transforms relationships between communities and health systems. Our findings challenge dominant narratives that treat trust as a communication problem rather than a governance issue. We present a "Trust Recovery Framework" that health authorities can apply during future outbreaks, emphasizing the need to integrate trust-building into core response mechanisms rather than treating it as a separate activity. |
| Presenters and affiliations |
Kevin Kapuku Thomas More University |
