The factors that influence citizen loyalty toward Union Health and Family Welfare Centers are examined in this study, with particular attention paid to the connections among service quality, public trust, satisfaction and loyalty in the provision of primary healthcare.
Using a structured survey and a quantitative approach, this study collected data from 439 respondents. The study uses structural equation modeling to identify both direct and indirect effects among the constructs, providing important new information on the factors determining citizen loyalty.
The results show that in public healthcare, service quality affects citizen loyalty indirectly through public trust (PT) and satisfaction (SA), rather than directly. Public trust emerged as the strongest driver of long-term engagement, while satisfaction served as a key mediator. These findings challenge traditional SQ–loyalty models and highlight the need to include mediating constructs in public health research to better capture loyalty dynamics.
The theoretical ramifications call for a rethinking of loyalty models to take nonlinear and contextual linkages into consideration.
The practical implication offers strategic recommendations for healthcare policymakers and administrators, advocating for a focus on enhancing public trust and satisfaction as core elements in citizen loyalty initiatives.
This study is original and new, having a substantial contribution to the primary healthcare scholarship by providing a model that can inform policy interventions aimed at fostering sustainable, citizen-centered healthcare services.
