ORCID Profile
0000-0003-4232-783X
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Publisher: Informa UK Limited
Date: 12-2010
Publisher: Wiley
Date: 28-01-2019
DOI: 10.1002/HEC.3858
Abstract: Government doctor absenteeism from their public posts is a sizable problem across developing economies. The consumer demand estimation for outpatient fever treatment presented in this paper investigates the interrelationship between government doctor absenteeism and the large informal healthcare sector. Using a counterfactual framework, this paper estimates treatment effect of eliminating government doctor absenteeism. The effects are measured by changes to the market share of government Bachelor of Medicine and Bachelor of Surgery (MBBS) providers and resulting own-price elasticities of demand for government MBBS providers and unqualified providers. Modelling incorporates patients expected health outcomes by provider via the use of a qualitative measure of word-of-mouth recommendations. Results indicate that eliminating government MBBS provider absenteeism in North India would increase utilisation of government outpatient fever treatments from 18% to 50%.
Publisher: Public Library of Science (PLoS)
Date: 06-07-2018
Publisher: Springer Science and Business Media LLC
Date: 24-10-2014
Publisher: Frontiers Media SA
Date: 15-10-2020
Publisher: Oxford University Press (OUP)
Date: 07-2019
Abstract: The private healthcare sector in low- and middle-income countries is increasingly seen as of public health importance, with widespread interest in improving private provider engagement. However, there is relatively little literature providing an in-depth understanding of the operation of private providers. We conducted a mixed methods analysis of the nature of competition faced by private delivery providers in Uttar Pradesh, India, where maternal mortality remains very high. We mapped health facilities in five contrasting districts, surveyed private facilities providing deliveries and conducted in-depth interviews with facility staff, allied providers (e.g. ambulance drivers, pathology laboratories) and other key informants. Over 3800 private facilities were mapped, of which 8% reported providing deliveries, mostly clustered in cities and larger towns. 89% of delivery facilities provided C-sections, but over half were not registered. Facilities were generally small, and the majority were independently owned, mostly by medical doctors and, to a lesser extent, AYUSH (non-biomedical) providers and others without formal qualifications. Recent growth in facility numbers had led to intense competition, particularly among mid-level facilities where customers were more price sensitive. In all facilities, nearly all payment was out-of-pocket, with very low-insurance coverage. Non-price competition was a key feature of the market and included location (preferably on highways or close to government facilities), medical infrastructure, hotel features, staff qualifications and reputation, and marketing. There was heavy reliance on visiting consultants such as obstetricians, surgeons and anaesthetists, and payment of hefty commission payments to agents who brought clients to the facility, for both new patients and those transferring from public facilities. Building on these insights, strategies for private sector engagement could include a foundation of universal facility registration, adaptation of accreditation schemes to lower-level facilities, improved third-party payment mechanisms and strategic purchasing, and enhanced patient information on facility availability, costs and quality.
Publisher: Public Library of Science (PLoS)
Date: 08-11-2022
DOI: 10.1371/JOURNAL.PGPH.0000690
Abstract: Growing empirical evidence indicates that financial anxiety causes reductions in short-term cognitive capacity. Results from urban communities in Delhi, India show sizable differences in the number of health events recalled between the poor and non-poor respondents over experimentally controlled recall periods. One explanation for this recall difference is ‘poor memory’. Such results provide additional reasons for healthy skepticism of the accuracy of self-reported health survey data. The present research identifies which forms of cognitive capacity are related to health event recall and assesses the roles of poverty and illiteracy as mediating variables. Results indicate that underreporting of health events among the poor in rural Kenya is not solely due to ‘poor memory’. Data used comes from a repeated cross-sectional study conducted in Samburu county, Kenya over 10-months between 2017–2018. This period coincided with the ending of a protracted and severe drought in East Africa. The results presented in the current study confirm the poor and non-poor distinction, but provide a more detailed cognitive explanation for such results. Reflective throught, as measured by fluid intelligence and heuristic use, is shown to be good predictors of fever recall among relatively poor rura communities in central Kenya.
Publisher: Journal of Artificial Societies and Social Simulation
Date: 2021
DOI: 10.18564/JASSS.4686
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.VACCINE.2019.01.072
Abstract: The study estimates cattle owners' willingness-to-pay (WTP) for Contagious Bovine Pleuropneumonia (CBPP) vaccine in Samburu county, Kenya. Of particular policy relevance, the study presents findings on WTP for i) improved access to vaccines and ii) timely access to disease-risk information. The mean price for a CBPP vaccine was estimated at KES 66 (USD 0.64). This price relates to a CBPP vaccine that requires a 1.8 h commute, cattle owners' receipt of timely information that the CBPP disease risk is low-moderate and the vaccine lowers the risk of either tail-drop or post-vaccine abortion. The conditional WTP for mean travel duration and high-risk information are similar at KES 53.9 and KES 51.5. The marginal effect on demand for a 1 h additional travel duration and provision of CBPP disease risk information was estimated as a 1.5 per cent reduction and 2.3 increase. The results of this study indicate that cattle owners value greater levels of knowledge concerning the changing risk profile of CBPP in their community and improved access to CBPP vaccination services. Enhanced engagement with cattle owners concerning CBPP would likely result in a greater utilisation of available CBPP vaccines, conditional on the perceived CBPP disease risk.
Publisher: Public Library of Science (PLoS)
Date: 03-03-2021
DOI: 10.1371/JOURNAL.PONE.0247008
Abstract: The increased exposure of pastoralist communities in East Africa to climatic shocks has focused attention on the resilience of these communities. Although many social scientists directly or indirectly infer versions of homo-economic agents, increasing evidence in development behavioral economics, indicates that such assumptions may be misplaced. Despite on-going advances in the science concerning the effects of stress on dynamic changes in short-term cognitive capacity, there remains limited understanding of the effects of changes in cognitive capacity on economic decision making. The present research empirically evaluates the drivers of short-term changes in cognitive capacity–cognitive ability and heuristic use–and its effect on crop and livestock expenditure among predominantly poor Kenyan agro-pastoralists. Three rounds of cognition and survey data from Samburu, Kenya is analysed. The primary data was collected at the end of the 2015–16 East African drought and covers an 11-month period between October 2016 and September 2017. Dynamic panel estimation, employing maximum likelihood, is used on balanced and unbalanced data. Results indicate that fluid intelligence and heuristic use, along with literacy and stressors, affect crop expenditure. Perceptions of scarcity, relative to prior expectations, are also identified as an important determinant of short-term changes in cognitive ability. These results underscore the importance of better understanding the effects of short-term changes in cognitive capacity on economic expenditure among the poor.
No related grants have been discovered for Richard Iles.