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Citation Information

Type Journal Article - Health and social protection: experiences from Cambodia, China, and Lao PDR. Studies in Health Services Organisation & Policy, Antwerp
Title What do we mean by ‘major illness’? The need for new approaches to research on the impact of ill-health on poverty
Author(s)
Volume 23
Publication (Day/Month/Year) 2008
Page numbers 29-54
URL http://www.chronicpoverty.org/uploads/publication_files/lucas_et_al_illness.pdf
Abstract
It is widely recognised that ill-health is one of the most serious challenges that many individuals, households and families have to face. But there is limited knowledge of the complex processes involved in suffering from and coping with multiple and diverse healthrelated challenges. Provision of support to those suffering ill-health has focused on acute illnesses which are often implicitly assumed to follow the pattern: get sick, consult with a provider, receive diagnosis, obtain treatment and recover. It has similarly become commonplace for economists to associate serious illness with ‘catastrophic health expenditure’. These presumptions have lead to support mechanisms being seen primarily in terms of providing assistance in meeting the cost of in-patient treatment. Such approaches fail to address the multiple and complex pathways which link ill-health and well-being. Individuals suffering from dengue fever, tuberculosis, mphysema, diabetes, lymphatic filariasis or AIDS might all be classified as having a ‘serious illness’. However, in terms of risk to life, level of disability and distress, duration of illness, prognosis, stigmatisation, availability and cost of treatment, and a range of other factors, their situations may differ radically. The impact of an illness is also highly dependent on the demographic and socio-economic characteristics of the individual falling ill, the household of which they
are a member and the extended family and social networks to which they belong. Research in Cambodia, China and Laos has focused on households affected by a ‘major illness’, defined broadly in terms of risk to household livelihoods. It was based on an innovative approach involving in-depth, one-year retrospective studies. Its purpose was to investigate the processes set in motion as different types of households coped with different types of health problem.

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