Nothing Special   »   [go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v69y2009i2p183-190.html
   My bibliography  Save this article

Idle chatter or learning? Evidence of social learning about clinicians and the health system from rural Tanzania

Author

Listed:
  • Leonard, Kenneth L.
  • Adelman, Sarah W.
  • Essam, Timothy
Abstract
We examine data from the rural Arusha region in Tanzania in which households are asked to recall the illness episodes of randomly chosen other households in their village. We interviewed 502 randomly selected households from 22 villages in 20 wards of Arusha. We analyze the probability that a household can recall another illness episode as a function of the characteristics of the illness, the location and type of health care chosen and the outcome experienced. We found that households are more likely to recall severe illnesses, illnesses for which good quality care is important, illnesses that resulted in visits to hospitals and illnesses when the patient was not cured. In addition, households are more likely to recall illnesses that resulted in a visit to a facility where the average tenure of clinicians is less than two years. The results suggest that households deliberately collect information in order to learn about clinicians and facilities in their local area. We show evidence that households use this information when they choose whether to visit new health care providers. In particular, households are less likely to visit a new provider when they hear of bad outcomes and more likely to do so when they hear of good outcomes.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:2:p:183-190
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00308-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    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. Gilson, Lucy, 2005. "Editorial: building trust and value in health systems in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 61(7), pages 1381-1384, October.
    2. Foster, Andrew D & Rosenzweig, Mark R, 1995. "Learning by Doing and Learning from Others: Human Capital and Technical Change in Agriculture," Journal of Political Economy, University of Chicago Press, vol. 103(6), pages 1176-1209, December.
    3. Timothy Conley & Udry Christopher, 2001. "Social Learning Through Networks: The Adoption of New Agricultural Technologies in Ghana," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 83(3), pages 668-673.
    4. H. Van Goor & A. Verhage, 1999. "Nonresponse and Recall Errors in a Study of Absence because of Illness: An Analysis of Their Effects on Distributions and Relationships," Quality & Quantity: International Journal of Methodology, Springer, vol. 33(4), pages 411-428, November.
    5. Timothy G. Conley & Christopher R. Udry, 2010. "Learning about a New Technology: Pineapple in Ghana," American Economic Review, American Economic Association, vol. 100(1), pages 35-69, March.
    6. Fafchamps, Marcel, 2000. "Ethnicity and credit in African manufacturing," Journal of Development Economics, Elsevier, vol. 61(1), pages 205-235, February.
    7. Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
    8. 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.
    9. Das, Jishnu & Hammer, Jeffrey, 2007. "Money for nothing: The dire straits of medical practice in Delhi, India," Journal of Development Economics, Elsevier, vol. 83(1), pages 1-36, May.
    10. Feder, Gershon & Just, Richard E & Zilberman, David, 1985. "Adoption of Agricultural Innovations in Developing Countries: A Survey," Economic Development and Cultural Change, University of Chicago Press, vol. 33(2), pages 255-298, January.
    11. Marcel Fafchamps & Bart Minten, 1999. "Relationships and traders in Madagascar," Journal of Development Studies, Taylor & Francis Journals, vol. 35(6), pages 1-35.
    12. Kenneth L. Leonard & Melkiory C. Masatu & Alexandre Vialou, 2007. "Getting Doctors to Do Their Best: The Roles of Ability and Motivation in Health Care Quality," Journal of Human Resources, University of Wisconsin Press, vol. 42(3).
    13. 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.
    14. Das, Jishnu & Hammer, Jeffrey, 2005. "Which doctor? Combining vignettes and item response to measure clinical competence," Journal of Development Economics, Elsevier, vol. 78(2), pages 348-383, December.
    15. Kenneth L. Leonard & Gilbert R. Mliga & Damen Haile Mariam, 2002. "Bypassing Health Centres in Tanzania: Revealed Preferences for Quality," Journal of African Economies, Centre for the Study of African Economies, vol. 11(4), pages 441-471, December.
    16. 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.
    17. Das, Jishnu & Das, Saumya, 2003. "Trust, learning, and vaccination: a case study of a North Indian village," Social Science & Medicine, Elsevier, vol. 57(1), pages 97-112, July.
    18. 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.
    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. Palmer, Jennifer J. & Kelly, Ann H. & Surur, Elizeous I. & Checchi, Francesco & Jones, Caroline, 2014. "Changing landscapes, changing practice: Negotiating access to sleeping sickness services in a post-conflict society," Social Science & Medicine, Elsevier, vol. 120(C), pages 396-404.
    2. Michael Richards, 2012. "Using the economics of certification to improve the safety and quality of male circumcision in developing countries," Applied Health Economics and Health Policy, Springer, vol. 10(2), pages 77-85, March.
    3. Richard A. Iles, 2019. "Government doctor absenteeism and its effects on consumer demand in rural north India," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 475-491, April.
    4. Kruk, Margaret E. & Rockers, Peter C. & Mbaruku, Godfrey & Paczkowski, Magdalena M. & Galea, Sandro, 2010. "Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis," Health Policy, Elsevier, vol. 97(2-3), pages 209-216, October.
    5. Ison, Ray & Blackmore, Chris & Iaquinto, Benjamin L., 2013. "Towards systemic and adaptive governance: Exploring the revealing and concealing aspects of contemporary social-learning metaphors," Ecological Economics, Elsevier, vol. 87(C), pages 34-42.
    6. ILes, Richard, 2017. "Government Doctor Absenteeism And Its Effects On Consumer Demand In Rural North India," Working Papers 2018-9, School of Economic Sciences, Washington State University, revised 12 2018.

    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. Adelman, Sarah W. & Essam, Timothy M. & Leonard, Kenneth L., 2008. "Idle Chatter or Learning? Evidence from Rural Tanzania of Social Learning about Clinicians and the Health System," Working Papers 42884, University of Maryland, Department of Agricultural and Resource Economics.
    2. Leonard, Kenneth L., 2009. "The cost of imperfect agency in health care: Evidence from rural Cameroun," Journal of Development Economics, Elsevier, vol. 88(2), pages 282-291, March.
    3. Leonard, David K. & Bloom, Gerald & Hanson, Kara & O’Farrell, Juan & Spicer, Neil, 2013. "Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor," World Development, Elsevier, vol. 48(C), pages 71-87.
    4. Sommarat Chantarat & Christopher Barrett, 2012. "Social network capital, economic mobility and poverty traps," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 10(3), pages 299-342, September.
    5. Timothy G. Conley & Christopher R. Udry, 2010. "Learning about a New Technology: Pineapple in Ghana," American Economic Review, American Economic Association, vol. 100(1), pages 35-69, March.
    6. Dsouza, Alwin & Mishra, Ashok. K., 2016. "Adoption and Abandonment of Conservation Technologies in Developing Economies: The Case of South Asia," 2016 Annual Meeting, July 31-August 2, Boston, Massachusetts 235243, Agricultural and Applied Economics Association.
    7. Margherita Comola & Carla Inguaggiato & Mariapia Mendola, 2021. "Learning about Farming: Innovation and Social Networks in a Resettled Community in Brazil," Development Working Papers 468, Centro Studi Luca d'Agliano, University of Milano.
    8. Christopher Udry & Timothy G. Conley, 2004. "Social Networks in Ghana," Working Papers 888, Economic Growth Center, Yale University.
    9. Grant Miller & A. Mushfiq Mobarak, 2013. "Gender Differences in Preferences, Intra-Household Externalities, and Low Demand for Improved Cookstoves," NBER Working Papers 18964, National Bureau of Economic Research, Inc.
    10. Kazushi Takahashi & Rie Muraoka & Keijiro Otsuka, 2020. "Technology adoption, impact, and extension in developing countries’ agriculture: A review of the recent literature," Agricultural Economics, International Association of Agricultural Economists, vol. 51(1), pages 31-45, January.
    11. Wang, Honglin & Yu, Fan & Reardon, Thomas & Huang, Jikun & Rozelle, Scott, 2013. "Social learning and parameter uncertainty in irreversible investments: Evidence from greenhouse adoption in northern China," China Economic Review, Elsevier, vol. 27(C), pages 104-120.
    12. 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.
    13. Gine, Xavier & Klonner, Stefan, 2005. "Credit constraints as a barrier to technology adoption by the poor : lessons from South Indian small-scale fishery," Policy Research Working Paper Series 3665, The World Bank.
    14. Heather Klemick & Kenneth L. Leonard & Melkiory C. Masatu, 2007. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 91(2), pages 347-358.
    15. 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.
    16. Mekonnen, Daniel Ayalew & Gerber, Nicolas & Matz, Julia Anna, 2018. "Gendered Social Networks, Agricultural Innovations, and Farm Productivity in Ethiopia," World Development, Elsevier, vol. 105(C), pages 321-335.
    17. Das, Jishnu & Hammer, Jeffrey & Sánchez-Paramo, Carolina, 2012. "The impact of recall periods on reported morbidity and health seeking behavior," Journal of Development Economics, Elsevier, vol. 98(1), pages 76-88.
    18. B Kelsey Jack, "undated". "Market Inefficiencies and the Adoption of Agricultural Technologies in Developing Countries," CID Working Papers 50, Center for International Development at Harvard University.
    19. Ghadir Asadi & Mohammad H. Mostafavi-Dehzooei, 2022. "The Role of Learning in Adaptation to Technology: The Case of Groundwater Extraction," Sustainability, MDPI, vol. 14(12), pages 1-37, June.

    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:69:y:2009:i:2:p:183-190. 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.