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Ill-health is one of the most serious challenges that many households have to face. This short paper from the Institute of Development Studies provides a background to catastrophic illness, health perceptions, attitudes and beliefs. The authors also consider health related interventions. They stress that in the design of interventions intended to counter health-related shocks, it is important to recognise the variety of existing social mechanisms established to cope with health challenges.

The authors discuss how most societies utilise a combination of universal entitlement programmes, targeted benefits and discretionary arrangements to help households cope with major illness, complementing a variety of “informal” community and family-based arrangements. The paper warns that it is dangerous to generalise, but the richer the society, the smaller its structural inequalities and the more sophisticated and stable its institutional arrangements the more likely are universal entitlements to play a significant role.  It is highlighted that there are major methodological challenges to be overcome in understanding health shocks. Research in this area entails the development of a range of innovative methodologies, combining quantitative and qualitative data. The design of appropriate support will almost certainly depend to a considerable extent on the existing situation in any given country. It is important for research to explore a wide range of national and local circumstances in order to assess the potential and limitations of different approaches.

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