In low and middle income countries (LMIC) the WHO estimates that between 20-40% of pharmaceuticals purchased and consumed may be sub-standard or falsified (SF). In this context of uncertainty in medicine quality, many people resort to a poorly regulated ‘informal’ herbal sector with substantial uncertainty about the quality of treatments on offer. In contexts where healthcare regulation is weak and levels of uncertainty high, how do patients decide whom to trust? In this paper, we apply the principles of Signalling Theory (ST) in order to address the empirical question – how, under conditions of uncertainty and informational asymmetry, do patients come to trust/distrust herbalists and their medicines?

Heather Hamill is Associate Professor of Sociology, University of Oxford.

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