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Abstract
Urban slums are human habitats with poor habitation qualities that are vulnerable to infectious diseases and public health crises. Low coverage from formal healthcare services providers created opportunity for informal providers to thrive in urban slums. This study examined the nature of relationship between informal and formal healthcare services providers in urban slums and explored opportunities for strengthening collaborations between them. Reconnaissance research method, a qualitative research approach for exploring under-researched terrains, guided the interview of 104 slum healthcare stakeholders across eight purposively selected slums in Enugu and Onitsha cities, in southeastern-Nigeria. Findings show that informal healthcare service providers are dominant in urban slums, and many of them cooperate and compete with formal providers. Supervision of informal providers in slums is inadequate, and the formal providers report that the informal providers find acceptance, despite their lack of adequate training and professionalism. Authorities governing health systems in slums are encouraged to establish a mechanism to profile informal providers, delineate the scope of services, and bridge the gap through the creation of referral channels. Subsequent studies may explore what character any mechanism created to institutionalize the collaboration toward improving healthcare services delivery should take and what challenges could undermine it.
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No potential conflict of interest was reported by the author(s).
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Notes on contributors
Paul Onuh
Paul Onuh holds a PhD in Political Economy. He has a teaching and research role in the department of Political Science, University of Nigeria, Nsukka. He researches political economy, public policy, health policy, security, environmental sustainability, and governance.
Prince Agwu
Prince Agwu holds a PhD in Social Policy and serves in teaching and research capacities at the University of Dundee, United Kingdom and University of Nigeria. He is an Associate Editor with the Health Research and Policy Systems journal and the African Section Editor of Social Work and Social Sciences Review. Prince has published remarkably in several refereed journals.
Chinyere Mbachu
Chinyere Mbachu is a Professor of community medicine, at the College of Medicine, University of Nigeria Enugu campus. She researches Health Policy and Systems, Sexual and Reproductive Health and Rights, and Implementation.
Obinna Onwujekwe
Obinna Onwujekwe is a Professor of Health Economics & Policy at the University of Nigeria Enugu Campus, and the Coordinator of the Health Policy Research Group, University of Nigeria. He researches Health Economics, Public Health, Health Policy and Systems Research, Pharmaco-economics, and Pharmaco-epidemiology.
Tim Ensor
Tim Ensor is a Professor of International Health Systems Research at the University of Leeds and former Head of the Nuffield Centre for International Health & Development. He was also Director of the Leeds Institute of Health Sciences. He is a health economist with more than 30 years of experience in teaching, research and consultancy across a range of low and middle-income countries.
Helen Elsey
Helen Elsey is a Professor of Global Public Health at the Department of Health Sciences, University of York. Helen’s research focuses on improving health and well-being of communities living in poor urban neighbourhoods in low income countries.
Mahua Das
Mahua Das is a Lecturer in International Health, at the School of Medicine, Leeds University, United Kingdom. Mahua holds a PhD in Sociology and Social Policy, and researches global health, health systems, community-based monitoring, participatory community-based approaches, applied qualitative health research, maternal health, sexual reproductive health, and urban health.