NOVAFRICA Working Paper: For Honor or for Profit? An Experiment on Recruiting Traditional Health Practitioners for Formal Healthcare in Guinea-Bissau

Traditional Health Practitioners (THPs) play a key role in healthcare across Sub-Saharan Africa, but integrating them into formal systems remains challenging. A new NOVAFRICA working paper tests two messaging strategies — emphasizing honor or profit. The study reveals that profit-based messages are more effective in encouraging THPs to engage with formal healthcare, particularly among those less religious or with prior formal system experience. These findings suggest that profit-driven incentives could help bridge the gap between traditional and formal healthcare systems.

Title:

For Honor or for Profit? An Experiment on Recruiting Traditional Health Practitioners for Formal Healthcare in Guinea-Bissau

Brais Álvarez-Pereira

Nova SBE, and NOVAFRICA

Mattia Fracchia

IE University, IE Business School, and NOVAFRICA

Teresa Molina-Millán

University of Alicante, and NOVAFRICA

Pedro C. Vicente

Nova SBE, BREAD, CEPR and NOVAFRICA

 
ISSN 2183-0843
Working Paper No 2502
March 2025

Abstract:

Sub-Saharan Africa still lags behind in most health indicators. At the same time, Traditional Health Practitioners (THPs) are central to healthcare in these countries. They are accessible, share the population’s traditional beliefs, and operate private businesses. We follow the recruitment of THPs to be trained and work akin to Community Health Workers in the formal healthcare system. We randomize messages regarding the program benefits: in one version we underline the pro-social benefits (honor); in the other we emphasize the pro-business benefits (profit). We find that the pro-business message increases THPs’ behavioral interest in the program relative to the other message, consistently with their perceived benefits of the program. This difference is driven by less religious THPs and those with previous collaborations with the formal healthcare system. Profit is likely to be a main motivator for the integration of THPs in the formal system.

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