Неформальное здравоохранение. Социографические очерки.
The monograph focuses on economic agents that substitute or complement the official healthcare system in modern Russia by serving alternative health maintenance practices. A detailed description of their activities is provided on the basis of an analysis of nationwide secondary data (public statistics, mass media, laws and regulations), as well as observations and interviews from the field research in the Perm region in 2013. The book consists of two parts. The first – introductory – chapter contains some generalizations and reflections on the subject matter in general. The following chapters are a series of independent sociographic essays that focus on selected "informal healthcare" phenomena classified by the principal product offered to the customers: goods, gifts of nature, diagnostic and treatment services, ideas/beliefs, or information. Among others, we consider direct selling of health products and itinerant trade in them; latent social functions of pharmacies; services of healers and doctors of alternative medicine; gathering and production of healing gifts of nature by private households; healing practices of religious organizations; and dissemination of self-treatment information in the mass media. The publication targets a wide audience, including professionals in healthcare management, social scientists, and everyone interested in health protection and the informal economy in Russia.
This article discusses the concept of medical activity for the purposes of criminal law enforcement. The article is intended to clarify terms such as conventional medicine, traditional medicine, alternative medicine. We investigate the legal nature and the possibility of criminal law protection of various types of medical activity, points to the shortcomings of the existing regulation. The author offers his own approach to the problem of criminal-legal protection of medical practice. After a theoretical analysis, the article examines the court sentences under Art. 235 of the Criminal Code of the Russian Federation ("Illegal occupation of private medical practice or private pharmaceutical activity").
The paper aims to portray and to discuss the informal impact of drugstores on health in Russia today, taking into account their formal role in the health care system. The empirical study was conducted in 2013 in the Perm region. It was a part of the larger project on description of all informal providers of goods and services for self-treatment in Russia.
According to our suggestion, if the pharmacies are commercial organizations, they inevitably adapt their work to customers’ demands. As a result, the tasks not designated by state policy are taking a prominent place in their work. In the terminology of R. Merton it could be called the latent (hidden) functions, i.e. unintentional and unconscious consequences of their activities. In order to describe them, we analysed the legislation and general statistics of drug sales in Russia, conducted 30 in-depth interviews with pharmacists, inspected around 50 pharmacies in different towns and villages, and specially registered all customers’ demands during two days in one pharmacy.
The peculiarities of the healthcare system and pharmaceutical retail in Russia may create conditions for a high level of self-medication and the proactive role of pharmacies in it. Nevertheless, in the Russian legislation the main reason for the existence of pharmacies is to provide remedies which are prescribed by doctors. It seems to mirror the classical, paternalistic model of health care. The legislative framework leads to the conservation of the hidden social functions of pharmacies, because deviations are widespread although illegal.
In sum, the empirical research demonstrates three main latent functions of pharmacies: to take on the duty of physician, to provide remedies for self-medication (whether conventional OTC and prescription medicines or food supplements, or alternative medicine), to serve addicted people and to help them in maintaining a destructive dependence. Each of them reveals in the various aspects of communications and implicit behavior rules in pharmacy. All of them work against formal healthcare.
This article presents an empirical study of the economic activity of the population. appearing in the form of craft s, that is the entrepreneur’s self-supporting activity aimed at household subsistence. Primary forms of such activity are self-employment, individual entrepreneurship and hiring. Th e purpose of this article is to describe the relationship between archaic and modern types of craft s in the local communities. As a result, the author elaborates the concept of the craft evolution. Th e craft s were diff erentiated into archaic (traditional) and modern. Archaic craft s exist for a long time (centuries and millennia) almost unchanged; they use natural and agricultural resources, and are oriented to old markets. Modern craft s have recently emerged; they use new resources, and are oriented to new markets. Th e fi eldwork was carried out in local communities in the south of Russia (Krasnodar region, Taman peninsula and Anapa district), where in 11 settlements (the town of Temryuk, 7 stanitsas (rural settlements), and 3 small urban settlements), materials were collected on all types of informal and formal occupations of the population. Th ey are gathered by methods of direct observation and non-formalized focused interview. In most local communities craft activity is diverse. Everywhere there are from one to three or more dozens of craft s. Most craft smen practice informal employment. In every local community there are both archaic (traditional) and modern craft s. Estimating the prevalence of household activities and the relationship between archaic and modern craft s allows us to identify three contrast groups of local communities: (1) communities with the prevalence of archaic craft s; (2) communities with an equally large number of both archaic and modern types of craft s; (3) communities with a reduction in craft activity, in which the population reoriented to modern craft s, which are organized on the basis of abundant resources from tourists. Th e comparison of the number of craft s with self-assessment of the population life quality shows that labor-consuming and not fully resourced archaic (traditional) craft s contribute to maintaining the high resilience of local communities against negative external infl uences. Th e reorientation of households to modern (usually abundant) resources with simultaneous abandonment of archaic economic practices and the reduction of the total number of craft s in the local community is accompanied (or leads) to a decrease in community’s stability. It is manifested in the assessment of the quality of relations between people, and in the criminalization of the local community (the growth of crime, drug addiction, prostitution). Th e author proposes a model of the craft s development the basis of which is the ratio of archaic (traditional) and modern types of craft s in the economic behavior of the population. Th e model allows predicting the dependence of the types of craft s in the local communities on the nature and features of the available resource base. It also allows assessing the development trends of the household’s craft activity, external threats, and the risks to the stability of local cocieties.
This volume deals with one of the most understudied aspects of everyday life in Russian society. Its main heroes are the providers of goods and services to whom people turn for healthcare instead of official medical institutions. A wide range of agents is described—from network marketing companies to 'folk' journals on health as well as healers, complementary medicine specialists, and religious organizations. Krasheninnikova’s book is based on rich empirical observations and avoids both positive and critical assessment of the analyzed phenomena. Her investigation pays particular attention to the legal, social, and economic status of informal healthcare providers. She demonstrates that these agents tend to flourish in bigger towns rather than in small settlements, where public healthcare is lacking. The study reveals the important role of institutions that are generally not related to alternative medicine, such as pharmacies, libraries, and church shops. The result is a vivid and thorough introduction to the world of self-medication and alternative healing in contemporary Russia. A special emphasis was made on the flexibility of boundaries between formal and informal healthcare due to the evolution of rules and regulations.
This study considers the influence of structutal change to aggregate labour productivity growth of the Russian economy. The term “structural change” refers to labour reallocation both between industries and between formal and informal segments within an industry. Using Russia KLEMS and official Rosstat data we decompose aggregate labour productivity growth into intra-industry (within) and between industry effects with four alternative methods of the shift share analysis. All methods provide consistent results and demonstrate that total labour reallocation has been growth enhancing though the informality expansion has had the negative effect. As our study suggests, it is caused by growing variation in productivity levels across industries.