Bamgboye Eniola A, Ogunwale Akintayo Olamide, Al-Mukhtar Adamu, Musa Bello, Mhlanga Laurette, Olawuwo Morenikeji, Fagbamigbe Adeniyi, Akinyemi Joshua, Ajayi IkeOluwapo, Ozodiegwu Ifeoma D
Department of Health Informatics and Data Science, Loyola University Chicago, Chicago, IL, USA.
Epidemiology and Biostatistics Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria.
Malar J. 2025 Jan 23;24(1):26. doi: 10.1186/s12936-025-05255-3.
Informal Healthcare Providers (IHCPs), including Proprietary Patent Medicine Vendors (PPMVs), drug peddlers, traditional healers, and herbal drug sellers are often the first choice for malaria treatment, especially in urban slums. Unplanned urbanization significantly impacts malaria transmission by creating cities with inadequate safety nets and healthcare access, increasing reliance on IHCPs. While the World Health Organization recognizes IHCP's crucial role and emphasizes integrating them into formal healthcare for improved malaria care, they lack requisite training in malaria management and operate outside official regulations, raising concerns about the quality of care they provide. Understanding IHCPs' perceptions and practices is essential for their proper integration. This study explored the perceived malaria burden, IHCPs' competence in malaria treatment, and reasons for visiting IHCPs in various urban settlements from both community member and provider perspectives.
This qualitative cross-sectional study was carried out in Ibadan and Kano metropolises. Eighteen Focus Group Discussions among 157 adult community members and twelve Key-Informant Interviews among PPMVs, drug peddlers, traditional healers and herbal drug sellers were conducted in these cities. Participants were drawn purposively from settlements-designated as formal, informal, and slum based on local definitions-in selected wards within the cities. Data were collected using pre-tested guides and analysed thematically.
This study reveals that malaria remains a significant health problem in these Nigerian cities. Patronage of IHCPs generally is driven by affordable treatment, perceived mildness of illness, and access to credit facilities. However, cultural belief was key to patronage of traditional healers and herbal drug sellers, largely among informal and slum residents. Furthermore, while IHCPs had a strong perceived competence in managing malaria cases, inadequate diagnosis and treatment were standard practices.
IHCPs remain consistently patronized across urban settlements. IHCPs are continuously patronized in all urban settlement. Educating and equipping IHCPs with diagnostic tools, enhancing access to affordable healthcare, and raising public awareness is crucial for proper malaria management and promoting collaborations with formal healthcare providers.
包括专利成药小贩、药品兜售者、传统治疗师和草药售卖者在内的非正规医疗服务提供者通常是疟疾治疗的首选，尤其是在城市贫民窟。无计划的城市化通过创建安全网和医疗服务不足的城市，显著影响疟疾传播，增加了对非正规医疗服务提供者的依赖。虽然世界卫生组织认识到非正规医疗服务提供者的关键作用，并强调将他们纳入正规医疗体系以改善疟疾治疗，但他们缺乏疟疾管理方面的必要培训，且在官方规定之外运营，这引发了对他们所提供医疗服务质量的担忧。了解非正规医疗服务提供者的认知和做法对于他们的恰当整合至关重要。本研究从社区成员和提供者的角度，探讨了不同城市住区中非正规医疗服务提供者对疟疾负担的认知、他们治疗疟疾的能力以及人们选择找他们看病的原因。
这项定性横断面研究在伊巴丹和卡诺大都市开展。在这些城市中，对157名成年社区成员进行了18次焦点小组讨论，并对专利成药小贩、药品兜售者、传统治疗师和草药售卖者进行了12次关键信息访谈。参与者是根据当地定义，从这些城市选定街区中指定为正规、非正规和贫民窟的住区中有目的地抽取的。使用预先测试的指南收集数据，并进行主题分析。
本研究表明，疟疾在这些尼日利亚城市仍然是一个重大的健康问题。一般来说，选择非正规医疗服务提供者看病是因为治疗费用可承受、感觉病情较轻以及能获得信贷便利。然而，文化信仰是选择传统治疗师和草药售卖者看病的关键因素，这在很大程度上存在于非正规住区和贫民窟居民中。此外，虽然非正规医疗服务提供者在管理疟疾病例方面有较强的自我认知能力，但诊断和治疗不足却是常见做法。
在各个城市住区，非正规医疗服务提供者一直受到青睐。在所有城市住区，非正规医疗服务提供者都持续受到光顾。对非正规医疗服务提供者进行教育并为其配备诊断工具、增加获得负担得起的医疗服务的机会以及提高公众意识，对于妥善管理疟疾以及促进与正规医疗服务提供者的合作至关重要。
