Access to medication for HIV/AIDS and malaria in Cameroon: illustrating the social construction of healthcare markets

Ngoasong, Michael Zisuh (2008). Access to medication for HIV/AIDS and malaria in Cameroon: illustrating the social construction of healthcare markets. In: Book of Abstracts, p. 470.

Abstract

Social scientists construct markets by combining two models of societal control: the market- plus-framework model and the opportunity-set model of power. The former focuses on the role of economics and the moral rules of society while the latter emphasises the opportunity available to every actor (legal rights, obligations and choices). By combining these two frameworks, social constructivists create an objective order of importance for each actor’s welfare in relation to the customs and interests of all actors. They also formulate governance structures, through which decisions made by a given actor impact on the opportunity set of other actors within the system. Very little has been written on the applicability of this approach in African countries, as much of the discussion on ‘markets’ is still dominated by neoclassical economics.

This paper therefore, discusses the applicability of the social construction of markets approach in explaining the historical attempts to establish a sustainable market for healthcare (as a public, private or public-private good) in Cameroon. The objective is to present a model of how healthcare market is created in African countries, how they function and how they can be modified. The empirical section explores the model further to consider the potential for free and/or discounted medication policy currently implemented by the government, to create a sustainable market for HIV/AIDS and Malaria treatment. The analysis focuses on open-ended interviews with representatives of bilateral and multilateral organizations, research and academia, international NGOs and donors, pharmaceutical companies, Ministry of Health, selected health care providers and civil society organizations involved with HIV/AIDS and malaria treatment and control in Cameroon. Analysis of the narratives from these stakeholders within the framework of the social construction of markets reveal important details about the characteristics of patients’ choices of healthcare providers in relation to their illness, health care delivery practices and costs of treatment, the nature and costs of agency in relation to actors’ behaviour and the diversity of healthcare markets that can be created.

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