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What's the role of trust in health promotion?

How to build it and why it's important 

7 May 2024
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Dr Saia Ma’u Piukala on stage at the World Health Summit Regional Meeting.
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This year’s World Health Summit Regional Meeting focused on shaping the future of health across Asia and Pacific.

Over this jam-packed-three-days we discussed opportunities and pathways towards a healthier, more equitable future.

Across the various sessions there was one core theme emerged: trust.

On the page, you'll find wisdom from global health experts, on how incredibly effective building trust is to creating better health outcomes.

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How to create a thriving community 

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Good health is a living reflection of the culture and values we hold as a society. It’s a sign of solidarity, respect and trust. Which is why we need to continue thinking about health challenges globally but start acting at a local level. 

Because local interventions are more effective, more equitable and more trustworthy. 

If health providers start thinking about public trust as an enabler to good societal health, we can create more unified and more resilient communities. But…

Trust isn’t a right, it has to be earned.

Dr Adnan Hyder
George Washington University, USA

So, how do we build community trust?

Listen to community 

People know their communities - they often know what is and isn't working for them and what they need (don't assume to know).

Build a relationship

Trust can’t be built unless you have a relationship. This takes time and has to be done in a meaningful and deliberate way.
 

Capacity building 

Recognise what others bring to the table and invite them to become active participants in their own health by building their capacity and capability to provide support. 

Address inequities 

If we can’t acknowledge where we’ve been then we can’t move forward equitably. Many communities face systemic and structural inequity. 
 

Inclusive decision making 

Ask yourself who should be at this table? Make sure diverse voices and perspectives from the community are being represented.  

Reflective practice 

Looking back helps inform better future decisions. 
 

Be adaptable

There’s no ‘one way’ to work with community, each collaboration is unique to that relationship. 
 

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Something to keep in mind

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There is an intrinsic vulnerability when it comes to conversations on health. This is amplified for communities facing greater barriers to good health. Which is why community engaged practice should never be seen as an 'add-on', instead, it should be deeply embedded in how we work. 

Building trust can be unpredictable and complex but it’s also essential if we want to create a healthier, more equitable future for everyone. 
 

If we don’t get it right, it will be the fate of tomorrow.

Dr Saia Ma’u Piukala
Regional Director for the Western Pacific, World Health Organization (WHO)
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Examples 

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True Collaboration

The establishment of the Māori Health Authority in New Zealand prioritizes self-determination and partnership, leading to improved outcomes through community-led initiatives and decision-making.

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Self-determination works

As demonstrated in how Indigenous community's handled COVID. They had five times fewer infection rates compared to non-Indigenous Australians, with Aboriginal-controlled health organisations leading response strategies.


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First Nations peoples in Australia were able to reverse initial disparities in the burden of COVID-19 when empowered by the government to lead their own response early in the pandemic. Indigenous sovereignty, coupled with a community-centred approach focused on cultural relevance and the use of Indigenous health-care providers.

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Another example of Indigenous self-determination: 

Archie Moore connection to country

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A Systems Approach to Health

The Marmot Cities initiative in the UK emphasises holistic approaches to health by addressing social determinants and involving communities in decision-making processes. 

A system approach to health is the foundation for our ten-year strategy.

Artwork by Dexx (Gunditjmara/Boon Wurrung) ‘Mobs Coming Together’ 2022
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VicHealth acknowledges the support of the Victorian Government.

Artwork Credit: Dexx (Gunditjmara/Boon Wurrung) ‘Mobs Coming Together’ 2022, acrylic on canvas. Learn more about this artwork.