Knowledge, legitimacy and economic practice in informal markets for medicine: A critical review of research

Cross, Jamie; MacGregor, Hayley

doi:10.1016/j.socscimed.2010.07.040

Cited by 53 publications

(67 citation statements)

References 46 publications

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“…These senior relatives had taken them on as apprentices. Informal providers not only work across the margins of legality, they also commonly work with "intermingling" medical streams (Khare 1996;Cross andMacGregor 2010: 1596;Bode, 2006;Frank and Ecks, 2004;Nisula, 2006;Datye et al, 2006).…”

Section: Career Entry and Trainingmentioning

confidence: 99%

“…Reviewing the literature on informal health providers in developing countries from an ethnographic position, Cross and MacGregor (2010) call for greater attention to how pharmaceutical supply chains, from manufacturers down to wholesalers and retailers, are shaping unlicensed prescription practices. Health policy interventions are based on rigid boundaries between experts and non-experts, and it is assumed that the dangers of informal prescribers need to -5 -be counterbalanced by more education and tighter surveillance.…”

mentioning

confidence: 99%

“…Health policy interventions are based on rigid boundaries between experts and non-experts, and it is assumed that the dangers of informal prescribers need to -5 -be counterbalanced by more education and tighter surveillance. Instead of placing "a substantial burden of responsibility for the delivery of health commodities and care on actors who occupy marginal or peripheral positions" (Cross andMacGregor 2010, p. 1599), more scrutiny should be given to the "higher levels of the biomedical supply chain" (2010, p. 1598). This paper examines antidepressant prescriptions by Indian Rural Medical Practitioners in this perspective, highlighting how RMPs are embedded in relations with the government, licensed doctors, patients, medical representatives, wholesalers, and retailers.…”

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confidence: 99%

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“We Always Live in Fear”: Antidepressant Prescriptions by Unlicensed Doctors in India

Ecks

Basu

2014

Cult Med Psychiatry

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SSRIs such as fluoxetine (Prozac). He estimated that, on average, one patient a day received an antidepressant drug from him. These patients complained of sleeping badly, feeling low, or not wanting to talk to anyone. SSRI antidepressants were effective treatments, but only if taken for at least three months. Unfortunately, few patients were willing to take drugs for such a long time.Previously he dispensed antidepressants "in large quantities," but people were less keen these days. Mr Ghosh also tried to minimize antidepressant prescriptions because patients needed a continuous, long-term supply, yet the illegality of his RMP practice did not allow him to stock drugs in greater quantities. Officially, RMPs have no license to act as medical prescribers, but in practice the government tolerates them because they fill deep gaps left by the state health system. Even more dangerous than prescribing was storing drugs without the required licenses: "We always live in fear. At any point in time, we might get arrested. The only crime is that we have such huge stocks of medicines without a valid drug license."This article explores how RMPs in rural India are using antidepressant drugs. Next to nothing is known about if and why informal providers, in India and other poorer countries, prescribe psychopharmaceuticals. This gap in the literature is surprising because both "global

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Section: Career Entry and Trainingmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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“We Always Live in Fear”: Antidepressant Prescriptions by Unlicensed Doctors in India

Ecks

Basu

2014

Cult Med Psychiatry

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“…The survival of folk medical practices were also arguably linked to migration, a form of 'cura in urbis', where rural traditions and practices were relocated and survived within urban settings. This too can be extended to contemporary work on CAM practice amongst migrant communities (Cross and MacGregor 2010). This final thematic concern for narrative-based medicine brings us back full circle to the contested relationships between scientific and talking cures and the increased attention and acceptance within medical humanities of narrative and belief-based medicine.…”

Section: Reputational Narrativesmentioning

confidence: 89%

“…Moore's Well in Kildare has long been used for post-natal blessings, particularly among members of Ireland's Travelling Community, a practice observed during those visits. This gendered perspective, especially as it relates to an embodied knowledge is certainly one which persists in a range of indigenous settings, where local cultural traditions associated with women's health have long and authentic histories (Cross and MacGregor 2010). Hufford also notes this as an especially good example of 'inappropriate notions about the boundaries of expert knowledge and authority', contrasting biomedical constructions of childbirth as a medical emergency against a reassertion by women of the authority of experience and traditional knowledge (1998,302).…”

Section: Authenticitymentioning

confidence: 99%

Indigenous Narratives of Health: (Re)Placing Folk-Medicine within Irish Health Histories

Foley

2014

J Med Humanit

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With the increased acceptance of complementary and alternative medicine (CAM) within society, new research reflects deeper folk health histories beyond formal medical spaces. The contested relationships between formal and informal medicine have deep provenance and as scientific medicine began to professionalise in the 19th century, lay health knowledges were simultaneously absorbed and disempowered (Porter 1997). In particular, the 'medical gaze' and the responses of informal medicine to this gaze were framed around themes of power, regulation, authenticity and narrative reputation. These responses were emplaced and mobile; enacted within multiple settings by multiple agents and structures over time. The work is drawn from secondary material from Ireland, which identify more indigenous narratives of health and act as potential sources for medical humanities. While assumptions have been made as to the place of folk-medicine being essentially rural, evidence will be presented which shows a more complex network of health beliefs and practices. The narratives of informal practice and folk-medicine drawn from evidence from Ireland point to more fluid and hybrid relations with formal medicine and suggest that the complementary nature of the two models reflected wider cultural debates and models of belief (Del Casino Jnr., Health & Place 10:59-73, 2004).

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Conditional cash transfers, spillovers, and informal health care: Evidence from Peru

2019

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The use of low-quality informal health-care providers (IHCPs) is still prominent in developing countries despite the efforts of their governments to expand institutional services. The use of conditional cash transfer (CCT) programs have become instrumental in encouraging the use of formal health services, but little is known about their direct effect on the use of IHCPs. We use a large survey of rural households and a regression discontinuity design to estimate the effects of the Peruvian CCT program on the demand for IHCP. We find a sizeable reduction in the use of IHCPs not only in targeted but also in non-targeted members of treated households. This finding indicates the existence of spillover effects within the household. We also provide evidence that beyond the direct increase in income, the availability of better information about institutional services is a potential mechanism that drives these effects. We also find a corresponding improvement in the self-perception of health status. Our results are robust to a number of sensitivity analyses.JEL Classification : C21, I18, O17

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Knowledge, legitimacy and economic practice in informal markets for medicine: A critical review of research

Cited by 53 publications

References 46 publications

“We Always Live in Fear”: Antidepressant Prescriptions by Unlicensed Doctors in India

“We Always Live in Fear”: Antidepressant Prescriptions by Unlicensed Doctors in India

Indigenous Narratives of Health: (Re)Placing Folk-Medicine within Irish Health Histories

Conditional cash transfers, spillovers, and informal health care: Evidence from Peru

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