Accepted paper:

A friend indeed? The facilitating role of mobile phones and social networks for healthcare access among marginalised groups in rural Thailand and Lao PDR

Authors:

Marco J Haenssgen (University of Warwick)
Giacomo Zanello (University of Reading)

Paper short abstract:

We study the behavioural implications of health-related mobile phone use among marginalised villagers in rural Thailand and Laos. Original survey data shows that mobile phones and social network support influence health behaviours in similar directions.

Paper long abstract:

The seeming "ubiquity" of mobile phones does not equate to widespread use during health emergencies. This paper studies digital inequality as a result of selective health-related adoption in low- and middle-income countries. Our research question is, "How does mobile phone use influence rural healthcare-seeking behaviours among marginalised groups?" We hypothesise that (1) resource constraints drive marginalised groups towards informal healthcare access, and that (2) mobile phone use and social support networks facilitate access to formal healthcare with a bias towards private doctors. We analyse representative survey data from 1,158 villagers in northern Thailand and 983 in southern Laos. Through multilevel regression analysis of access-to-healthcare models, we present evidence that: (a) People who use mobile phones during an illness are less likely to be marginalised, whereas this is not the case for people activating their social network during an illness. (b) Marginalised groups have idiosyncratic behaviours when they experience an illness or accident. (c) Among marginalised groups, mobile phones and social network support influence health behaviours in similar directions with increased access to public healthcare providers. Our findings confirm comparable research from rural India and China. However, while mobile phones appear to advantage more privileged groups, they do not yet seem to crowd out social support. The analysis leads us to conclude that mobile phone diffusion on our field sites appears to have a mildly positive effect on rural healthcare access among the poor, but risks persist that socially excluded groups are left out of these developments.

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panel J1
Digital development [paper]