Informal practises in Russian pharmacies

Thesis Eleanor Robertson

Eleanor Robertson’s thesis work investigated how informality functions in Russian healthcare. She focused on the case of pharmacists’ work and its relation to the treatment of Opisthorchiasis, a parasitic disease endemic to Western Siberia. Here is an abstract of Eleanor’s successfully finalised thesis.

Background

Informality is a global phenomenon, influencing all aspects of public life. It permeates all levels of economic, social and political practice. In healthcare, informal practice pertains to all health maintenance related activities that fall outside requirements determined by conventional medicine, or the governing state. The interaction between formal and informal practice in healthcare is currently not well understood. Development of knowledge in this area could shed light on the significance of informality in the implementation of any public health intervention program.

Objective

This study aimed to explore the intertwinement of formal and informal practice within the healthcare sector. To achieve this, a case study was undertaken of pharmacists regarding Opisthorchiasis, a major public health concern in Tomsk, Western Siberia.

Methods

This qualitative study involved twenty-one in-depth interviews with pharmacists working in the Tomsk region, exploring their perceptions and practices in the treatment of Opisthorchiasis. In addition, participant observations were completed.

Results

This study sets out the formal and informal roles that pharmacies play in the treatment of Opisthorchiasis. Pharmacists were found to undertake a context specific mixture of formal and informal practices. These practices were found to both shape and be shaped by larger sociotechnical processes at play.

Discussion

A model has been created to illustrate the dynamic relationship between the nature of the formal treatment avenue, societal demand and the practices of healthcare professionals. It is recommended that this model be used as a guide by which to analyse healthcare organisation and practices in other cases and settings. Any formulation of an effective public health intervention, must consider informal practice and its dynamic interaction with the wider sociotechnical processes at play.