Informal providers (IPs)– the plethora of independent and largely unregulated health care practitioners – are a vital source of care for many in lower- and middle-income countries. They include traditional healers, herbalists, and drug sellers, and medical practitioners. According to some estimates, IPs comprise more than 50% of healthcare workers in India and close to 96% in rural Bangladesh. They are utilized for a wide variety of health interventions and often represent the first point of care for patients, particularly the poor. Although IPs are heavily utilized, they pose a number of challenges. They generally have little formally recognized training and operate outside of the scope of regulatory authority. As a result, the quality of their care is not well known. However, IPs appear to have strong local roots and well-established, long-running practices that effectively reach the most remote and difficult to access populations. Integrating IPs and their unique strengths into health programming interventions could have incredible potential for expanding health care access.
CHMI documents a number of programs working with informal providers attempting to harness this potential to increase care access. Cambodian Medicinal Plants Project, a program that promotes medicinal plants, trains traditional healers to recognize basic diseases and to refer patients to qualified health providers when there are evident danger signs. Boma la Mama, a two-year training program for traditional birth attendants, operates in the Arusha region of Tanzania to formally train and accredit these providers with life-saving skills and other competencies. In Afghanistan, the Holistic Health for Mother and Baby program distribute health kits at organized workshops for women and traditional birth attendants, which provide detailed information pertaining to pregnancy, including facts on complications, breast-feeding, and risk factors. 94.7% of participants gave birth in a clinic or hospital in the first year compared to the 15% national average.
This topics page details CHMI-documented programs that engage informal providers in healthcare delivery and features resources describing fieldwork commissioned from Bangladesh, India, and Nigeria to explore the characteristics of informal providers and the dynamics of their interaction with the broader health system.
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ADDO is a donor-supported initiative led by the Tanzanian Food and Drug Authority to train and license small, privately operated retail outlets in rural and poor areas to sell a set list of essential medicines, including selected prescription drugs.