How social norms and values shape household healthcare expenditures and resource allocation
Insights from India
Bibliographic Data
| ID | 4893118 |
|---|---|
| Authors | Sumit Kane (0000-0002-4858-7344, The George Institute for Global Health, corresponding author), Madhura Joshi (0009-0002-1048-497X, Gokhale Institute of Politics and Economics), Akhira Mahal (0000-0002-7246-3261, The George Institute for Global Health), Barbara Mcpake (0000-0002-9904-1077, The George Institute for Global Health) |
| Year | 2023 |
| Volume | 336 |
| Pages | 116286 |
| Publication date | 2023-11-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2023.116286 |
| PMID | 37797542 |
| OpenAlex | W4387082108 |
| Language | EN |
| Citations received | 2 |
| References cited | 25 |
We present a novel perspective on thinking about and studying healthcare spending in contexts where few health-related financial risk protection mechanisms exist and where out-of-pocket spending by households is the norm. Drawing on interviews conducted across 20 villages in two states of India, we illustrate and problematize how a complex interplay of social norms and cultural factors underpin spending decisions within households in such contexts. While our analysis draws on the fieldwork at large, we present our findings through selected narratives - stories of patients suffering from chronic breathlessness. We engage with and reveal the various ways in which social norms dynamically drive this household economy, and shape resource allocation-related decisions. We conclude that in health system contexts where out-of-pocket spending by households is the norm, it is essential to recognise the pragmatic and calculative nature of intra-household allocation of resources, and how it involves bargaining and negotiations at the intersection of social norms, economic class, caste, gender, age, and productive status. And at the same time, how all of this occurs within the economy of the family, and how it plays out differently for different members of a family is also important to recognise. Such recognition can not only help one better appreciate how this household level economy may sometimes maintain and perpetuate entrenched hierarchies and gender inequities, crucially, it can help target health related social protection policies and strategies and make them more responsive to the needs of the most vulnerable in the society and within households
Caste · Economic growth · Economics · Health care · Negotiation · Norm (philosophy · Political science · Public economics · Social determinants of health · Social protection · Social science · Sociology · Gender, Labor, and Family Dynamics · Global Health Care Issues · Global Maternal and Child Health
Descriptive Translation Studies – and beyond
On Writing Qualitative Research
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Untreated Reproductive Morbidities among Ever Married Women of Slums of Rajkot City, Gujarat
Gender Bias in Resource Allocation in India
Bargaining'' and Gender Relations
The Intra-Household Economics of Voice and Exit
Social Norms and Economic Theory
People's care seeking journey for a chronic illness in rural India
Illness Narratives Revisited
The Moral Economy of the Peasant
Moral economy
Accounts of health and illness
| Citations per year | 2 |
|---|---|
| Citation span | 2025 - 2026 (2) |
| Highly cited | No |