Determinants of parental reports of children's illnesses: empirical evidence from Nepal

Household surveys from the developing world consistently record a generally low level of illness reporting, but the evidence that substantial differences exist in illness reporting between income groups is scanty. In contrast, a huge gap in illness reporting exists between rich and poor countries. Medical anthropologists have highlighted the differential illness perception across income groups but little is known as to what extent economic variables do determine one's illness decision. In this paper, discrete choice theory is used to explain why some parents choose to report their children's illnesses more often than others in Nepal. An empirical model is developed that depicts illness-reporting decisions as a function of inter alia, price and income. Data are drawn from Phase I of the Nepal Living Standards Survey. The results suggest that income as well as the price that parents expect to pay on treatment of their children's non-chronic ailments determine their decision to report an illness, when controlling for other variables (price responsiveness =-1.16; income responsiveness=0.23; p-value=0.00). This behaviour is theoretically consistent as parents weigh the opportunity costs of their decision (here, choosing to report an illness). Its implications are broader and raise other questions, e.g., Can we explain the difference in illness-perception rates between rich and poor countries that have different mechanisms to finance health care?