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Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria

Listed author(s):
  • Sieverding, Maia
  • Liu, Jenny
  • Beyeler, Naomi
Registered author(s):

    The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953615300897
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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 143 (2015)
    Issue (Month): C ()
    Pages: 17-25

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    Handle: RePEc:eee:socmed:v:143:y:2015:i:c:p:17-25
    DOI: 10.1016/j.socscimed.2015.08.037
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    1. George, Asha & Iyer, Aditi, 2013. "Unfree markets: Socially embedded informal health providers in northern Karnataka, India," Social Science & Medicine, Elsevier, vol. 96(C), pages 297-304.
    2. Zuwarimwe, J. & Kirsten, Johann F., 2010. "The role of social networks in development of small-scale enterprises in the Chimanimani district of Zimbabwe," Agrekon, Agricultural Economics Association of South Africa (AEASA), vol. 49(1), March.
    3. Marcel Fafchamps, 2002. "Returns to social network capital among traders," Oxford Economic Papers, Oxford University Press, vol. 54(2), pages 173-206, April.
    4. Lyon, Fergus, 2000. "Trust, Networks and Norms: The Creation of Social Capital in Agricultural Economies in Ghana," World Development, Elsevier, vol. 28(4), pages 663-681, April.
    5. Sloan, Frank A., 2000. "Not-for-profit ownership and hospital behavior," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 21, pages 1141-1174 Elsevier.
    6. Cross, Jamie & MacGregor, Hayley Nan, 2010. "Knowledge, legitimacy and economic practice in informal markets for medicine: A critical review of research," Social Science & Medicine, Elsevier, vol. 71(9), pages 1593-1600, November.
    7. Barr, Abigail, 2000. "Social Capital and Technical Information Flows in the Ghanaian Manufacturing Sector," Oxford Economic Papers, Oxford University Press, vol. 52(3), pages 539-559, July.
    8. Bloom, Gerald & Standing, Hilary & Lloyd, Robert, 2008. "Markets, information asymmetry and health care: Towards new social contracts," Social Science & Medicine, Elsevier, vol. 66(10), pages 2076-2087, May.
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