“…Drawing from this theorisation, the following hypothesis is proposed to be tested: H1: The higher the formal-informal institution misalignment the greater the propensity to make informal payments to healthcare practitioners in the public healthcare sector. Surprisingly, despite a large number of studies investigating the informal economy which underline the important role of the social norms (27)(28)(29)(30)(31), this has been under-researched in respect of the informal payments made by patients (24). Social norms represent the trust between the actors in a society (32) and, in this context, amongst the patients and healthcare professionals.…”