The Salience of Trust to the Client-Provider Relationship in Post-Ebola Guinea: Findings From a Qualitative Study

This qualitative study in post-Ebola Guinea showed that trust was a salient construct for clients making health care-seeking decisions in a postemergency setting. This analysis argues for global health programs to build trust between clients and the health system by addressing underlying domains of trust as defined by the clients themselves.

• Specific people? (i.e. health care providers, husband, mother-in-law, friends, other family members) 3. When your child is sick, how do you decide where and when to seek help?
• Walk us through how you manage your care when your child is sick?
• Receiving treatment including finding and asking permission, decisionmaking related to treatment-seeking (preventive versus curative) • How does this change for prevention services such as immunizations?
• What is your first line of health care for your child? What do you do?
Where do you go first? With whom do you talk to first?
4. Please tell me about the last time you or your child was sick. What was the situation?
• What was the first thing that you did? And after that?
• How did this situation affect your daily routine that you told me about before?
5. No I am going to ask you some questions about the last time you went to the local health center? (Get a sense of the illness/condition and how they handled it) • How would you describe the doctor/nurse/other staff at the health center?
• How was the welcome?
• What were things that you liked about your visit?
• How were you made to feel?
• Did you feel like your wellbeing mattered to them?
• What did they do to make you feel this way?
• What were some of the good things you experienced? Bad things?
• What could have been done to make your visit better?
• What could the local health center do to make a woman feel more at ease? 3. Please tell me about a typical health care consult that you might have with a client/patient.
• What is the process from when you first go to meet a patient to when the visit is finished? • When a client leaves, how do you know if he/she is pleased with the care received?
4. What would you say is the most rewarding thing about being a ________________ (specify type of provider that respondent is)?
• What would you say is the most rewarding thing about being a __________ (specify type of provider that respondent is) at this hospital/health center/community? • Explain why they are here-describe focus group • The purpose of this group discussion is to learn about the places people like you go for health care, your experiences in regards to the care you have received, and your thoughts about your local health center. • Your feedback and input is very helpful to us. We will be using it to help us in our work with local health centers to improve quality of care they provide.

C. Expectations
Before we get started, I want to explain a few things about how we will work during our time together: • As you have been told before, you can choose whether or not you wish to talk . You can also choose to leave at any point during our time talking. • We will be on first name basis tonight (hence the name tags), but names will not be included in our final report • I will be recording our discussion to make sure that I do not miss any comments. I will be the only person that will listen to the recording, which I will use when I type up what we discussed. • Please speak one at a time and speak up (especially since recorder will garble voices if too many speak at once) but you do not have to wait for me to call on you. • Feel free to express when you do not agree with something someone said, as we are trying to gather many viewpoints-there are no right or wrong answers. Please do not forget to respect what other people say. Also, make sure others get a chance to speak. • We have a lot to cover in a short period of time, so I will be moving from one thing to the next somewhat quickly. If you have something you want to add and I move on, please feel free to stop me and express your thoughts. • We will talk for no more than 2 hours. • Your feedback and input is very helpful to us. We will be using it to help us in our work with local health centers to improve quality of care they provide.

D. Expectations
Before we get started, I want to explain a few things about how we will be working together throughout our discussions: • As you have been told before, you can choose whether or not you wish to talk . You can also choose to leave at any point during our time talking. • We will be on first name basis tonight (hence the name tags), but names will not be included in our final report • I will be recording our discussion to make sure that I do not miss any comments. I will be the only person that will listen to the recording, which I will use when I type up what we discussed. • Please speak one at a time and speak up (especially since recorder will garble voices if too many speak at once) but you do not have to wait for me to call on you. • Feel free to express when you do not agree with something someone said, as we are trying to gather many viewpoints-there are no right or wrong answers. Please do not forget to respect what other people say. Also, make sure others get a chance to speak. • We have a lot to cover in a short period of time, so I will be moving from one thing to the next somewhat quickly. If you have something you want to add and I move on, please feel free to stop me and express your thoughts. • We will talk for no more than 2 hours.

Warm-up 10 minutes
1. Please share with us the following: • First name • Age • Where you live and with whom Your favorite thing about being a grandmother of young children