WHICH RESOURCES PAY FOR TREATMENT - A MODEL FOR ESTIMATING THE INFORMAL ECONOMY OF HEALTH

The model proposed is a means for (i) documenting the resources a woma n deploys to choose, seek, find, get and pay for treatment; (ii) compa ring what she has/does with a neighbour facing similar symptoms and pr oblems, and (iii) understanding which difference between them makes mo st difference to the way they manage illness. In a narrow economic per spective, only tangible items with easily enumerated values are called resources, and only the formal economy counts. This model allows asse ssment of the value of both formal and informal resources in the house hold system. It will not establish the absolute or market worth of hou seholds in the sample, but does offer a framework for comparing househ olds which have the same access to a given set of treatment options wh en faced with the same symptoms. Its application improves the possibil ity of understanding which resources, or combinations of resources, ma ke most difference to a household's capacity to seek and get the treat ment it has decided it needs. The paper is one element of a multi-laye red and multi-disciplinary study of 'The Informal Economy of Health in African Cities'. The overall project aims are (i) to map the cultural , infrastructural and clinical factors affecting the treatment-seeking behaviour of women in low-income urban areas; (ii) to compare their e ffect(s) on the management of symptoms of adult venereal infection (ST D) and crisis symptoms in children under five. The project mapped the social context of illness management In a district of Kampala. Importa nt dimensions of that context are: the infrastructure of the area, and the treatment options available in or around it; women's assessments of how good/kind/shameful/private/feasible/appropriate those options a re, and the social and physical signs which trigger the conclusion tha t a symptom is 'serious enough' to need treatment outside the home in the first place. The focus here is the value of resources mobilized af ter the 'serious enough' assessment has been made. (For a wider pictur e, see Kampala Women Gelling By. James Currey, London, 1996.