Coping with the costs of illness: the role of shops and shopkeepers as social networks in a low‐income community in coastal Kenya

AbstractThe role of shops as an important first source of treatment for many illnesses is well documented. Far less attention has been directed towards the broader role that shops and shopkeepers may play in household coping behaviour, for example by offering credit to help meet the direct and indirect costs of illness, and to cope with other socio‐economic needs. This exploratory paper draws on the data collected as part of a wider study on affordability of health care to consider the ‘multiple’ roles that shops and shopkeepers play in households' financing of illness related costs. The findings support the potential of working with shopkeepers to design and implement interventions that identify and reach the poor, but also highlight important challenges, including inequities in access to shop services, and the complex relationships that shopkeepers have with their clients. We suggest further specifically designed studies to explore the issues in more detail, to test the transferability of the findings to other settings, and to consider the implications for policy and practice. Copyright © 2009 John Wiley & Sons, Ltd.