Correction: What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review

Abstract

Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed.

Antibiotic Prescribing by Informal Healthcare Providers for Common Illnesses: A Repeated Cross-Sectional Study in Rural India

“…Failure of the public healthcare system has resulted in the evolution of private healthcare systems [8], which cater to 78% and 60% of outpatients and inpatients, respectively, in India [11]. In many Asian countries where healthcare systems are weak, healthcare tends to shift into the hands of informal healthcare providers (IHCPs) [12]. IHCPs are defined as healthcare providers who have not received a formal degree in medicine from any institution and are not registered as healthcare practitioners with any governing body.…”

“…IHCPs are defined as healthcare providers who have not received a formal degree in medicine from any institution and are not registered as healthcare practitioners with any governing body. While some may have received some informal training, they are not certified by any formal institute [12]. In India, IHCPs include unqualified doctors, spiritual healers, unqualified drug vendors, and traditional birth attendants [9,13,14,15], and this informal cadre constitutes more than half of all active healthcare providers in rural India [9].…”

Localizing Global Medicine: Challenges and Opportunities in Cervical Screening in an Indigenous Community in Ecuador

“…There has been increasing momentum among policy makers, practitioners, and researchers in the global health community to bring the apparent benefits of allopathic medicine to underresourced communities (Green, 1998; Sudhinaraset, Ingram, Lofthouse, & Montagu, 2013). The character of the networks in which allopathic medicine operates is different from health-seeking practices that are unique to particular local communities.…”

Social networks for health communication in rural Uganda: A mixed-method analysis of Dekabusa Trading Centre, Luwero County

“…When studies do describe communal health systems, including informal health workers, they typically pay less attention to information and communication networks (e.g. Sudhinaraset et al, 2013). Some exceptions exist.…”