Abstract
This paper presents a conceptual approach for discussing health information seeking among poor households in Africa and Asia. This approach is part of a larger research endeavor aimed at understanding how health systems are adapting; with possibilities and constraints emerging. These health systems can be found in a context of the changing relationships between states, markets and civil society in low and middle income countries. The paper starts from an understanding of the health sector as a “health knowledge economy”, organized to provide people with access to knowledge and advice. The use of the term “health knowledge economy” draws attention to the ways the health sector is part of a broader knowledge economy changing the way individuals and households obtain and use specialist information. The paper integrates an actor centric approach with the theory of planned behavior. It seeks to identify the actors engaged in the health knowledge economy as a precursor to longer term studies on the uptake of innovations integrating health services with mobile phones, commonly designated as mHealth, contributing to an understanding of the potential vulnerabilities of poor people, and highlighting possible dangers if providers of health information and advice are strongly influenced by interest groups.
Highlights
This paper examines health information seeking in Bangladesh from an actor-centric perspective.This is part of a larger research endeavor aimed at understanding the pluralistic health systems, which have emerged in a context of changing relationships between states, markets, and civil society in many low and middle-income countries [1]
In the actor-centric approach outlined below, we model the complexity of the health system, as well as show the intricacies associated with information seeking and decisions about treatment
Drawing on Batchelor et al [18], the paper presents an actor-centric approach for discussing health information seeking behavior by the poor, using an example from qualitative research to illustrate its application. The paper integrates this approach with the theory of planned behavior, which leads one to pose critical questions such as: Who holds the trust or respect of the people enough that they might act upon advice? What channels of information are used by the public? Where are people seeking their health information, both passively and actively? Addressing these questions helps illuminate new ways in which information and communication technologies (ICT) might be used to support health systems and for developing new applications which seek to meet the needs of the poor and disenfranchised
Summary
This paper examines health information seeking in Bangladesh from an actor-centric perspective. A major influence on the organization of health systems is the asymmetry of information between the providers and users of expert medical knowledge [7] This has resulted historically in the creation of self-regulating professions, a variety of accreditation mechanisms and government provision of services to ensure that experts are competent and act in the interests of their clients. These arrangements are under pressure because of a growing tendency for people to bypass specialist “gatekeepers” to knowledge, such as trained professionals, and seek information, advice and goods, such as drugs, either directly or via non-regulated providers. The paper integrates this approach with the theory of planned behavior, which leads one to pose critical questions such as: Who holds the trust or respect of the people enough that they might act upon advice? What channels of information are used by the public? Where are people seeking their health information, both passively and actively? Addressing these questions helps illuminate new ways in which ICTs might be used to support health systems and for developing new applications which seek to meet the needs of the poor and disenfranchised
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