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

Sudhinaraset, May; Ingram, Matthew; Lofthouse, Heather Kinlaw; Montagu, Dominic
February 2013
PLoS ONE;Feb2013, Vol. 8 Issue 2, p1
Academic Journal
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.


Related Articles

  • The international classification for functioning, disability and health. Boonen, Annelies; Rasker, Johannes J.; Stucki, Gerold // Clinical Rheumatology;Nov2007, Vol. 26 Issue 11, p1803 

    The author reflects on the international classification of functioning, disability, and health (ICF). He highlights the important role of ICF in obtaining information related to the areas that are important for global functioning like body functions and structures, activities, and participation....

  • HIT adoption key to provider success under healthcare reform. Mendelson, Dan; Johnson, Erik // hfm (Healthcare Financial Management);Jun2011, Vol. 65 Issue 6, p128 

    The article focuses on the significance to develop a strong healthcare information technology (HIT) system to address the immediate challenges in line with the implementation of the Affordable Care Act in the U.S. It stresses the need of chief financial officers (CFOs) to decide issues on how to...

  • Status of national health research systems in ten countries of the WHO African Region. Kirigia, Joses M.; Wambebe, Charles // BMC Health Services Research;2006, Vol. 6, p135 

    Background: The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through...

  • Planning an integrated disease surveillance and response system: a matrix of skills and activities. Perry, Helen N.; McDonnell, Sharon M; Alemu, Wondimagegnehu; Nsubuga, Peter; Chungong, Stella; Otten Jr, Mac W.; Lusambadikassa, Paul S.; Thacker, Stephen B. // BMC Medicine;2007, Vol. 5, p24 

    Background: The threat of a global influenza pandemic and the adoption of the World Health Organization (WHO) International Health Regulations (2005) highlight the value of wellcoordinated, functional disease surveillance systems. The resulting demand for timely information challenges public...

  • La valutazione dei Piani regionali di prevenzione. Vasselli, Stefania; Federici, Antonio; Filippetti, Giuseppe // Rassegna Italiana di Valutazione;2011, Vol. 15 Issue 50, p41 

    National Prevention Plan (NPP), adopted with the State-Regional Government Agreement of 29 April 2010, is an innovative experience for contents (wide range of objectives in the fields of health promotion, primary, secondary and tertiary prevention), methodology (a common logical framework for...

  • Maternal, Perinatal and Neonatal Mortality 1n South-East Asia Region. Sharma, Gaurav // Asian Journal of Epidemiology;2011, Vol. 4 Issue 2, p1 

    South East Asia Region (SEAR) is one of the most populous world regions and also bears a disproportionate burden of mortality compared to other world regions. The purpose of this article was to analyze the situation of maternal, neonatal and perinatal health in SEAR to inform public health...

  • Survival Strategies for ICD-10. Snyder, Kim // Imaging Economics;Jun2011, Vol. 24 Issue 5, p12 

    The article presents the author's views on the use of International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) in the U.S. She mentions that radiology groups have an in-house billing operation share concern regarding the readiness of their software...

  • Healing health systems in fragile states. Kwalombota, Kwalombota // Africa Health;May2013, Vol. 35 Issue 4, p41 

    The article focuses on the need of strengthening of the health care system in fragile states. A number of projects in fragile states across the world are demonstrating the importance of government-led health system. also focus on longer-term strategies. Health systems strengthening and...

  • World Health Organization Guideline Development: An Evaluation Sinclair, David; Isba, Rachel; Kredo, Tamara; Zani, Babalwa; Smith, Helen; Garner, Paul // PLoS ONE;May2013, Vol. 8 Issue 5, p1 

    Background: Research in 2007 showed that World Health Organization (WHO) recommendations were largely based on expert opinion, rarely used systematic evidence-based methods, and did not follow the organization's own “Guidelines for Guidelines”. In response, the WHO established a...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics