This book is a report of a qualitative study of “informal” healthcare practices and attitudes that have not been institutionalized by the Russian state and take place largely outside of professional medicine. “Informal” health care is an all-encompassing term in this book that also includes “traditional” medicine and complementary and alternative medicine (CAM). The study was conducted in 2013 by Yulia Krasheninnikova, the author of this book, and her research team at the Higher School of Economics Perm΄ Campus, where she is an Associate Professor of Public Administration. Krasheninnikova is also a candidate for a doctorate in the history of science at the Higher School of Economics in Moscow.

The study utilized “sociographic” methods consisting initially of an extensive review of information from public sources (official statistics, laws and regulations, mass media, corporate websites, public databases, and the like), followed by a series of semi-structured interviews with local experts (such as government officials, physicians, and public figures), and residents, along with field observations. The research was carried out in Perm΄ Territory, which is described by the author as not a leading area in Russia nor an outsider. The level of health in the region is depicted as generally lower than the national average but not dramatically lower as in some other regions. “Informal” healthcare in this locale was considered more of a reflection of national patterns than a strictly local phenomenon.

The book is divided into two parts, with the first chapter describing the study and its methodology and the second consisting of chapters on agents in the healthcare market (namely, physicians who serve as paid experts for some health products, such as dietary supplements, and marketing by direct-selling companies, along with pharmacies and peddlers likewise engaged in direct selling); the gathering, cultivating, selling, and buying of products procured from nature (medicinal plants, herbs, honey, and various “informal” practitioners such as natural healers, CAM specialists), and licensed psychotherapists used as an alternative to orthodox medicine; religious ceremonies and rituals (including the sale of healing products such as honey, oils, tinctures, and the like in church shops); and the mass media, including the internet, newspapers, magazines, and books, as a source of information for products and self-treatment (the information market).

Additionally, there is coverage of state laws and regulations pertaining to the market for health products. While their aim is to protect consumers, there is often a lack of personnel and resources to enforce the existing regulations and regularly supervise such activities. Krasheninnikova finds that the authorities often turn a “blind-eye” to legal violations in this area, unless there are direct complaints about them from the public. She notes that few complaints are ever filed. Thus, “informal” healthcare largely operates on an informal basis outside of Russia's official economy.

From the book's organization it is clear that this study is not about why Russians use “informal’ healthcare (the author says this is a “banal” question because obviously the formal system of health care delivery does not meet their needs), but rather it is on the economics of such healthcare. Consequently, there is considerable information about the infrastructure that supports “informal” healthcare and the “informal” market that exists, but very little on the users of such care. Moreover, despite the qualitative character of the study, there are few first-person accounts of the activities taking place. If a reader is thus looking for detailed information into why these forms of alternative medicine persist and the social background of the people who are its customers, there may be some disappointment. However, the author is clear that this is not what her book is about. Rather, it is a study of the marketplace that supports this so-called shadow economy, and this approach is novel. It addresses an important void in the literature on CAM and other alternative forms of healing and healthcare that is generally unavailable. In this respect, Krasheninnikova has made an important contribution to the literature.