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

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  • 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.

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  • 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
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    References listed on IDEAS

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    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)

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    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).
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    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).

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