IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v188y2017icp109-118.html
   My bibliography  Save this article

The application of Signalling Theory to health-related trust problems: The example of herbal clinics in Ghana and Tanzania

Author

Listed:
  • Hampshire, Kate
  • Hamill, Heather
  • Mariwah, Simon
  • Mwanga, Joseph
  • Amoako-Sakyi, Daniel

Abstract

In contexts where healthcare regulation is weak and levels of uncertainty high, how do patients decide whom and what to trust? In this paper, we explore the potential for using Signalling Theory (ST, a form of Behavioural Game Theory) to investigate health-related trust problems under conditions of uncertainty, using the empirical example of ‘herbal clinics’ in Ghana and Tanzania. Qualitative, ethnographic fieldwork was conducted over an eight-month period (2015–2016) in eight herbal clinics in Ghana and ten in Tanzania, including semi-structured interviews with herbalists (N = 18) and patients (N = 68), plus detailed ethnographic observations and twenty additional key informant interviews. The data were used to explore four ST-derived predictions, relating to herbalists' strategic communication (‘signalling’) of their trustworthiness to patients, and patients' interpretation of those signals. Signalling Theory is shown to provide a useful analytical framework, allowing us to go beyond the primary trust problem addressed by other researchers – cataloguing observable indicators of trustworthiness – and providing tools for tackling the trickier secondary trust problem, where the trustworthiness of those indicators must be ascertained. Signalling Theory also enables a basis for comparative work between different empirical contexts that share the underlying condition of uncertainty.

Suggested Citation

  • Hampshire, Kate & Hamill, Heather & Mariwah, Simon & Mwanga, Joseph & Amoako-Sakyi, Daniel, 2017. "The application of Signalling Theory to health-related trust problems: The example of herbal clinics in Ghana and Tanzania," Social Science & Medicine, Elsevier, vol. 188(C), pages 109-118.
    • Handle: RePEc:eee:socmed:v:188:y:2017:i:c:p:109-118
    DOI: 10.1016/j.socscimed.2017.07.009
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953617304422
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2017.07.009?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Blair, Robert A. & Morse, Benjamin S. & Tsai, Lily L., 2017. "Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia," Social Science & Medicine, Elsevier, vol. 172(C), pages 89-97.
    2. Tibandebage, Paula & Mackintosh, Maureen, 2005. "The market shaping of charges, trust and abuse: health care transactions in Tanzania," Social Science & Medicine, Elsevier, vol. 61(7), pages 1385-1395, October.
    3. McMillen, H.Heather, 2004. "The adapting healer: pioneering through shifting epidemiological and sociocultural landscapes," Social Science & Medicine, Elsevier, vol. 59(5), pages 889-902, September.
    4. Tsey, Komla, 1997. "Traditional medicine in contemporary Ghana: A public policy analysis," Social Science & Medicine, Elsevier, vol. 45(7), pages 1065-1074, October.
    5. Vijayaprasad Gopichandran & Satish Kumar Chetlapalli, 2013. "Dimensions and Determinants of Trust in Health Care in Resource Poor Settings – A Qualitative Exploration," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-8, July.
    6. George A. Akerlof, 1970. "The Market for "Lemons": Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 84(3), pages 488-500.
    7. Mechanic, David & Meyer, Sharon, 2000. "Concepts of trust among patients with serious illness," Social Science & Medicine, Elsevier, vol. 51(5), pages 657-668, September.
    8. Ackatia-Armah, Nana M. & Addy, Nii Antiaye & Ghosh, Shibani & Dubé, Laurette, 2016. "Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa," Social Science & Medicine, Elsevier, vol. 158(C), pages 96-104.
    9. Russell, Steven, 2005. "Treatment-seeking behaviour in urban Sri Lanka: Trusting the state, trusting private providers," Social Science & Medicine, Elsevier, vol. 61(7), pages 1396-1407, October.
    10. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    11. Birungi, Harriet, 1998. "Injections and self-help: risk and trust in Ugandan health care," Social Science & Medicine, Elsevier, vol. 47(10), pages 1455-1462, November.
    12. Gilson, Lucy & Palmer, Natasha & Schneider, Helen, 2005. "Trust and health worker performance: exploring a conceptual framework using South African evidence," Social Science & Medicine, Elsevier, vol. 61(7), pages 1418-1429, October.
    13. Michael Spence, 1973. "Job Market Signaling," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 87(3), pages 355-374.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Panter-Brick, Catherine & Eggerman, Mark, 2018. "The field of medical anthropology in Social Science & Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 233-239.
    2. Tuğba Koç & Fatih Çevik, 2022. "Building Trust in E-Commerce: A Practical Trust Guide for Evaluation," Alphanumeric Journal, Bahadir Fatih Yildirim, vol. 10(2), pages 167-184, December.
    3. Adnan Muhammad Shah & Wazir Muhammad & Kangyoon Lee & Rizwan Ali Naqvi, 2021. "Examining Different Factors in Web-Based Patients’ Decision-Making Process: Systematic Review on Digital Platforms for Clinical Decision Support System," IJERPH, MDPI, vol. 18(21), pages 1-23, October.
    4. Habib Zare & Madjid Tavana & Abbas Mardani & Sepideh Masoudian & Mahyar Kamali Saraji, 2019. "A hybrid data envelopment analysis and game theory model for performance measurement in healthcare," Health Care Management Science, Springer, vol. 22(3), pages 475-488, September.
    5. Rodrigues, Carla F., 2021. "Communicative trust in therapeutic encounters: users’ experiences in public healthcare facilities and community pharmacies in Maputo, Mozambique," Social Science & Medicine, Elsevier, vol. 291(C).
    6. Hamill, Heather & Hampshire, Kate & Mariwah, Simon & Amoako-Sakyi, Daniel & Kyei, Abigail & Castelli, Michele, 2019. "Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context," Social Science & Medicine, Elsevier, vol. 234(C), pages 1-1.
    7. Xiao, Lin & Li, Xiaofeng & Zhang, Yucheng, 2023. "Exploring the factors influencing consumer engagement behavior regarding short-form video advertising: A big data perspective," Journal of Retailing and Consumer Services, Elsevier, vol. 70(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hamill, Heather & Hampshire, Kate & Mariwah, Simon & Amoako-Sakyi, Daniel & Kyei, Abigail & Castelli, Michele, 2019. "Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context," Social Science & Medicine, Elsevier, vol. 234(C), pages 1-1.
    2. Megan M McLaughlin & Louis Simonson & Xia Zou & Li Ling & Joseph D Tucker, 2015. "African Migrant Patients’ Trust in Chinese Physicians: A Social Ecological Approach to Understanding Patient-Physician Trust," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    3. Mohseni, Mohabbat & Lindstrom, Martin, 2007. "Social capital, trust in the health-care system and self-rated health: The role of access to health care in a population-based study," Social Science & Medicine, Elsevier, vol. 64(7), pages 1373-1383, April.
    4. Smirnova, Michelle & Owens, Jennifer Gatewood, 2017. "Medicalized addiction, self-medication, or nonmedical prescription drug use? How trust figures into incarcerated women's conceptualization of illicit prescription drug use," Social Science & Medicine, Elsevier, vol. 183(C), pages 106-115.
    5. Stasiulis, Elaine & Gibson, Barbara E. & Webster, Fiona & Boydell, Katherine M., 2020. "Resisting governance and the production of trust in early psychosis intervention," Social Science & Medicine, Elsevier, vol. 253(C).
    6. Arakelyan, Stella & Jailobaeva, Kanykey & Dakessian, Arek & Diaconu, Karin & Caperon, Lizzie & Strang, Alison & Bou-Orm, Ibrahim R. & Witter, Sophie & Ager, Alastair, 2021. "The role of trust in health-seeking for non-communicable disease services in fragile contexts: A cross-country comparative study," Social Science & Medicine, Elsevier, vol. 291(C).
    7. Ozawa, Sachiko & Sripad, Pooja, 2013. "How do you measure trust in the health system? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 91(C), pages 10-14.
    8. Goudge, Jane & Gilson, Lucy, 2005. "How can trust be investigated? Drawing lessons from past experience," Social Science & Medicine, Elsevier, vol. 61(7), pages 1439-1451, October.
    9. Leonard, Kenneth L. & Adelman, Sarah W. & Essam, Timothy, 2009. "Idle chatter or learning? Evidence of social learning about clinicians and the health system from rural Tanzania," Social Science & Medicine, Elsevier, vol. 69(2), pages 183-190, July.
    10. Rodrigues, Carla F., 2021. "Communicative trust in therapeutic encounters: users’ experiences in public healthcare facilities and community pharmacies in Maputo, Mozambique," Social Science & Medicine, Elsevier, vol. 291(C).
    11. Ezumah, Nkoli & Manzano, Ana & Ezenwaka, Uchenna & Obi, Uche & Ensor, Tim & Etiaba, Enyi & Onwujekwe, Obinna & Ebenso, Bassey & Uzochukwu, Benjamin & Huss, Reinhard & Mirzoev, Tolib, 2022. "Role of trust in sustaining provision and uptake of maternal and child healthcare: Evidence from a national programme in Nigeria," Social Science & Medicine, Elsevier, vol. 293(C).
    12. Russell, Steven, 2005. "Treatment-seeking behaviour in urban Sri Lanka: Trusting the state, trusting private providers," Social Science & Medicine, Elsevier, vol. 61(7), pages 1396-1407, October.
    13. Molyneux, C.S. & Peshu, N. & Marsh, K., 2005. "Trust and informed consent: insights from community members on the Kenyan coast," Social Science & Medicine, Elsevier, vol. 61(7), pages 1463-1473, October.
    14. Wilk, Adam S. & Platt, Jodyn E., 2016. "Measuring physicians' trust: A scoping review with implications for public policy," Social Science & Medicine, Elsevier, vol. 165(C), pages 75-81.
    15. 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.
    16. Gilson, Lucy & Palmer, Natasha & Schneider, Helen, 2005. "Trust and health worker performance: exploring a conceptual framework using South African evidence," Social Science & Medicine, Elsevier, vol. 61(7), pages 1418-1429, October.
    17. Teela, Katherine C. & Mullany, Luke C. & Lee, Catherine I. & Poh, Eh & Paw, Palae & Masenior, Nicole & Maung, Cynthia & Beyrer, Chris & Lee, Thomas J., 2009. "Community-based delivery of maternal care in conflict-affected areas of eastern Burma: Perspectives from lay maternal health workers," Social Science & Medicine, Elsevier, vol. 68(7), pages 1332-1340, April.
    18. Feser, Daniel & Runst, Petrik, 2015. "Energy efficiency consultants as change agents? Examining the reasons for EECs’ limited success," ifh Working Papers 1 (2015), Volkswirtschaftliches Institut für Mittelstand und Handwerk an der Universität Göttingen (ifh).
    19. Dionne, G. & Doherty, N., 1991. "Adverse Selection In Insurance Markets: A Selective Survey," Cahiers de recherche 9105, Centre interuniversitaire de recherche en économie quantitative, CIREQ.
    20. Michele Dell'Era & Luis Santos-Pinto, 2011. "Entrepreneurial Overconfidence, Self-Financing and Capital Market Efficiency," Cahiers de Recherches Economiques du Département d'économie 11.06, Université de Lausanne, Faculté des HEC, Département d’économie, revised Nov 2012.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:188:y:2017:i:c:p:109-118. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.