Trust in the Healthcare System and COVID-19 Treatment in the Developing World. Survey and Experimental Evidence from Armenia

Concerns are looming that the healthcare systems in low- and middle- income countries (LMICs) are mostly unprepared to combat COVID-19 because of limited resources. The problems in LMICs are exacerbated by the fact that citizens in these countries generally exhibit low trust in the healthcare system, which could trigger a number of uncooperative behaviors. In this paper, we focus on one such behavior and investigate the relationship between trust in the healthcare system and the likelihood of potential treatment-seeking behavior upon the appearance of the first symptoms of COVID-19. First, we provide motivating evidence from a unique national on-line survey administered in Armenia — a post-Soviet LMIC country. We then present results from a large-scale survey experiment in Armenia that provides causal evidence in support of the investigated relationship. Our main finding is that a more trustworthy healthcare system enhances the likelihood of potential treatment-seeking behavior when observing the initial symptoms.