Re-imagining community trust in primary health care service delivery in Nigeria: policy lessons from Rwanda
Omowunmi Boboye ORCID ↗ · Nirmala Dorasamy
International Journal of Research in Business and Social Science · 2026 · Vol. 15 / Issue 4 · 438-447
Publication metrics
External links open provider records or DOI searches. Provider counts are not combined. Mendeley readership measures saves, not citations.
Dimensions
Live provider badge. If unavailable, use the Dimensions link above.
Observed 21 Oct 2026, 07:22 UTC
Observed 21 Oct 2026 07:23 UTC
Observed 21 Oct 2026 22:59 UTC
OpenAlex and Mendeley observations refresh on article visits, at most once per 24 hours. Unavailable data is not zero. Google Scholar opens a DOI search.
Citations received by this article, grouped by the year of the citing work. Crossref and OpenAlex lifetime totals remain separate in Publication metrics.
2017–2026 Annual history last updated:
Citations received
OpenAlex · year of the citing work
Hover over a year or focus the chart and use arrow keys to inspect values.
2017–2026 annual-history window. 2026 is year to date. Unknown years have gaps.
View data & coverage
2026 is incomplete. Within a successfully fetched ten-year window, omitted years mean zero. Years beyond a saved observation’s window remain unknown (—). Older citations are excluded, so this chart’s sum may differ from the OpenAlex lifetime total. The date above belongs to this annual history; an unsuccessful refresh keeps the previous observation.
Abstract
This article employs a structured, theory-guided comparative policy analysis to examine the persistent deficits in community trust that undermine primary health care (PHC) service delivery in Nigeria. Despite numerous reforms targeting financing and administrative structures, PHC utilization remains low and citizen confidence fragile. Drawing on policy learning theory, this study argues that Nigeria’s PHC reforms have predominantly involved first-order, instrumental adjustments, failing to foster deeper shifts in governance philosophy or state-citizen relations essential for building trust. Using Rwanda as a contrasting case, the analysis illustrates how its post-genocide PHC reconstruction leveraged second- and third-order policy learning to embed community trust within governance through co-production, robust accountability mechanisms, and deliberate institutional design. The paper identifies context-sensitive policy lessons for Nigeria, emphasizing that trust must be recognized and actively governed as a strategic resource for legitimate, responsive, and sustainable PHC systems, rather than merely a residual outcome of service delivery.
Keywords: {'name': 'Community trust, Primary healthcare (PHC), Service Delivery, Policy Learning, Governance, Nigeria, Rwanda'}
Authors & affiliations
Omowunmi Boboye
Durban University of Technology
Nirmala Dorasamy
Durban University of Technology
Deposited references
Supplied references, not a list of publications citing this article.
DOI: 10.63950/gshh.2025.1.2.19
Adeyokun, M. Investigating the Nexus between Poverty, Financial Crises, Public Debt, and Insecurity in Nigeria: A Holistic Perspective, React Humanities and Social Sciences, 191): 20-29.
DOI: 10.2147/IPRP.S387354
African Health Business.2021. Rwanda’s Health Sector. Available:https://www.ahb.co.ke/wp-content/uploads/2021/07/Rwanda-Overview-Snapshot.
DOI: 10.1371/journal.pgph.0000566
DOI: 10.1080/23288604.2022.2124601
Amakiri, J., & Arugu, L. O. (2025). Policy Implementation and Local Government Administration in Nigeria: Bridging the Gap between Policy and Practice. UKR Journal of Education and Literature (UKRJEL), 1(1): 51-60.
DOI: 10.3390/ijerph20216998
Egwuaba, E. U., & Sunday, B. A. (2025). Challenges In Health Care Delivery, Health-Seeking Behaviour And Implementing Social Behavioral Strategies In Awka, Nigeria. GVU Journal of Management and Social Sciences, 10(1), 218-233. https://doi.org/10.5281/zenodo.15814374.
DOI: 10.52589/JARMS-AAQQDLCJ
DOI: 10.47772/IJRISS.2025.90300201
DOI: 10.1371/journal.pgph.0003651
DOI: 10.1002/puh2.70125
DOI: 10.1177/20503121251352974
DOI: 10.1371/journal.pgph.0004860
DOI: 10.33545/26646021.2024.v6.i1c.316
DOI: 10.1136/bmjgh-2025-021339
DOI: 10.21522/TIJAR.2014.09.03.Art006
DOI: 10.30574/wjarr.2024.21.2.0421
Igechi, O. G., Efanodor-Obeten, H. O., & Atoe, K. (2025). The politics of healthcare in Nigeria: an analysis of policy implementation and outcomes. Salus et Scientia, 1(1), 14-26.
DOI: 10.1002/epa2.70006
DOI: 10.1371/journal.pone.0318244
Lucky, P. (2024). Progress in the Wake of Destruction: a Theoretical Analysis of Post-Genocide Rwandan Public Health Funding. Intersect: The Stanford Journal of Science, Technology, and Society, 17(2): 1-13.
DOI: 10.1108/IJSE-01-2023-0059
DOI: 10.1186/s12913-025-12605-z
DOI: 10.1136/bmjopen-2021-055119
DOI: 10.54536/ajds.v1i2.2099
DOI: 10.12691/ajbr-11-1-1
Nwire, S. O., Nwakamma, M. C., Nwigwe, C. N., Chukwuma, C. E., Nwaedu, F. N., & Ogiji, V. M. (2024). Community Participation and Challenges of Primary Healthcare Service Delivery In Rural Areas Of Ebonyi State, Nigeria. South East Political Science Review, 9(1): 321-332.
DOI: 10.11604/pamj.2020.37.55.20376
DOI: 10.59657/2837-8172.brs.23.030
DOI: 10.1007/s10389-022-01814-z
Okunlola, K. A., Oreofe, I., Ohaeri, B., & Babarimisa, O. (2025). Challenges Facing Primary Health Care Services Utilization and Possible Solutions, Euro Global Contemporary Studies Journal, 5(2), 1-12. DOI: 10.5281/zenodo.15382527.
DOI: 10.4103/jphpc.jphpc_20_25
DOI: 10.2196/50745
DOI: 10.1186/s12982-025-01321-y
Owutuamo, E. M., & Chilaka, F. C. (2025). Public Health Policy and Local Government Responses in NIGERIA: Lessons from the COVID-19 Pandemic. UKR Journal of Medicine and Medical Research (UKRJMMR), 1(1): 16-31.
DOI: 10.1186/s12961-024-01204-9
DOI: 10.9745/GHSP-D-23-00429
DOI: 10.46404/panjogov.v6i1.6191
DOI: 10.1016/j.landusepol.2023.106939
Prabowo, Y. (2025). Drone-based healthcare service delivery in rural areas: A systematic review. Journal of Medical Systems, 49(1), 1-10.https://doi.org/10.1007/s10916-025-02100-x.
DOI: 10.5001/omj.2023.10
Schurer, J. M., Niyigena, A., Nshimyiryo, A., Dushime, T., Nsanzimana, S., & Kateera, F. (2020). Community health workers in Rwanda: a systematic review of their roles, challenges, and opportunities. Human Resources for Health, 18(1), 1-15.https://doi.org/10.1186/s12960-020-00531-0.
DOI: 10.1111/jrh.12789
DOI: 10.1093/heapol/czac087
DOI: 10.17496/kmer.25.004
Sserwanja, I., Gatasi, G., & Musaba, M. (2025). Community health workers in Rwanda: A qualitative study on their experiences and challenges. Journal of Community Health, 50(1), 1-8.https://doi.org/10.1007/s10900-025-01600-x.
Tuyisenge, G., Crooks, V. A., & Berry, N. S. (2020). The role of community health workers in promoting health-seeking behaviours in Rwanda: a qualitative study. BMC Health Services Research, 20(1), 1-10.https://doi.org/10.1186/s12913-020-05700-1.
DOI: 10.1093/heapol/czac090
Ugwu, C. (2025). The political economy of health sector reform in Nigeria: A critical analysis. Journal of Public Policy in Africa, 12(1), 1-15.
Umar, S., Adebayo, A., & Ibrahim, M. (2025). Medical tourism in Nigeria: Trends, challenges, and policy implications. Journal of Health Management, 27(1), 1-10.
Weber, A., Niyigena, A., Nshimyiryo, A., Dushime, T., Nsanzimana, S., & Kateera, F. (2020). Community health workers in Rwanda: a systematic review of their roles, challenges, and opportunities. Human Resources for Health, 18(1), 1-15.https://doi.org/10.1186/s12960-020-00531-0.
Zhang, L., Wang, Y., & Fu, H. (2025). The role of trust in patient-provider relationships: A systematic review. Patient Education and Counseling, 108(1), 1-10.https://doi.org/10.1016/j.pec.2024.10.001.