Exploring the role and nature of trust in institutional capacity building in low- and middle-income countries: a systematic review

Abstract

Background Global concern with strengthening institutions is evident and has been underscored in the wake of the COVID-19 pandemic. Trusted or trustworthy institutions are vital in addressing institutional capacity strengthening, but there is limited research on institutional trust and how to build it. A preliminary approach entitled, Trusted Institutions (TI), identifies six essential elements of trust including: team culture, autonomy, scale and longevity, commitment to quality and ethics, sustainability, and good fit with local context and culture. We aimed to explore capacity building initiatives and the notion of ‘trust’ within non-government health institutions in low- and middle-income countries (LMICs) and validate these essential elements of trust through a systematic review.Methods We searched the published literature in PubMed and EMBASE in March 2020 and employed a three-concept search that included “health-related institutions”; “capacity building”; and “LMICs”. The study team used PRISMA reporting guidelines to conduct title and full-text reviews and conduct data extraction and analysis.Results The search yielded 342 unique articles. Seventy-seven references met initial inclusion criteria and underwent full-text extraction; 31 studies were included in the final analysis. Capacity building activities ranged from individual-level skills to institutional systems and structures. All articles addressed at least one element of trust with over half of articles describing sustainability (n = 18; 58%) and good fit with local context and culture (n = 18; 58%). Only 14 (45%) of articles explicitly mentioned the concept of trust either within an institution (intra-institutional) or between two or more institutions (interinstitutional). Four additional themes emerged as relevant to institutional trust including collaboration, communication, extent of institutional networks, and intersectionality.Conclusions This review validates essential elements of trust in the TI approach and documents the importance of building trust both within and between institutions. The TI approach can be used by public health institutions in LMICs to enhance their abilities to achieve institutional missions and meet global targets.

Strengthening national public health institutes: a systematic review on institution building in the public sector

“…Organizations should strengthen and promote effective leadership at all levels ( 22 , 45 , 84 ), enabling “innovative, coordinate, capable bureaucracy and (local) governments” ( 44 ). The establishment of an autonomous organization, with local ownership, not driven from external funders ( 40 ) and with independence in management and protected from political influence, is an important strategy to avoid misuse of power and partisan interference ( 5 , 10 , 45 ). Empowered leadership ( 40 ) and the appointment of a board of directors ( 45 ) are important factors in institution building, as well as the creation of “safe spaces” for mediation and exchange of ideas between stakeholders in a “non-accusatory manner” ( 58 ).…”

“…The establishment of an autonomous organization, with local ownership, not driven from external funders ( 40 ) and with independence in management and protected from political influence, is an important strategy to avoid misuse of power and partisan interference ( 5 , 10 , 45 ). Empowered leadership ( 40 ) and the appointment of a board of directors ( 45 ) are important factors in institution building, as well as the creation of “safe spaces” for mediation and exchange of ideas between stakeholders in a “non-accusatory manner” ( 58 ). In one publication on strengthening research institutes in Africa, the authors described the importance of senior actors (university vice-chancellors, deans, and senior researchers) leadership in lobbying for policymakers` commitment to evidence-based policy and resource mobilization ( 41 ).…”

“…Still, the involvement with clients, users, and other actors is a stronger predictor of institutional quality ( 5 , 10 , 31 , 44 , 56 , 66 ). Use of staff experience or local (health) priorities to elaborate plans and strategies ensures “consensus-building,” ownership, adequacy and sustainability of organizations and institutions ( 40 , 58 ). For example, the engagement of partners ensured that decisions of policymakers in specific research topics focused on main public needs, strengthening the capacities of the involved institution, the Ministry of Health ( 62 ).…”

Sustainability of Palm Oil Business Partnerships through the Role of Social Capital and Local Wisdom: Evidence from Palm Oil Plantations in Indonesia

“…Having rich resources also promotes the trust of farmers in their partner company. Besley and Dray (2022) argue that trust in government leads to greater policy compliance, thereby increasing state capacity, whilst Manoj et al (2020) emphasise the importance of trust within and between institutions in capacity building. In sum, trust is one of the keys to enhancing community and institutional capacity.…”

Best practice recommendations for healthy work environments for nurses: An integrative literature review

“…Teamwork and collaboration are important in a health care team. Nurses play a vital role in health professional teams to ensure that the health system provides improved access to health services, high-quality patient care and sustainable and affordable health care systems (Manoj, Brough & Kalbarczyk 2020 ).…”