1998 Reports

African Traditional Healers: Incentives and Skill in Health Care Delivery

Leonard, Kenneth L.

The benefit of health care comes not just from the ability of health care providers to produce health but from their motivation to do so as well. The fact that traditional healers in Africa are paid on the basis of health outcomes not services provided changes the incentives they face compared to those of modern health care providers. This paper documents these payment methods in Cameroun and explores the different incentives faced by practitioners in government and church-based facilities as well as traditional healers. To test whether such incentives make a difference in the provision of health care I use a multinomial logit analysis of an original data set from Cameroun on patients' choice of provider and show that patients choose practitioners as if they were aware of the difference in incentives. Thus, though patients cannot perfectly evaluate the quality of health they receive or would have received, they can evaluate expected quality by examining incentives.