Unregulated health markets have spread rapidly in low- and middle-income countries, in most cases faster than regulatory frameworks to ensure quality of care and equity in access. Yet international bodies like the World Health Organisation continue to ignore these actors, researchers from the Future Health Systems consortium argue in a new commentary in Nature.
In the first five-year phase of the Future Health Systems Research Consortium, country studies in Bangladesh, India and Nigeria highlighted the importance of these informal providers, variously referred to as ‘village doctors’, ‘rural medical practitioners’, ‘patent medicine vendors’. In Chakaria, a rural area of Bangladesh, ICDDR,B researchers found that these informally trained ‘village doctors’ are often the first port of call for the poor.
Cross-country findings from FHS studies have been compiled in forthcoming book, Transforming Health Markets in Asia and Africa: Improving quality and access for the poor, which is now available for pre-order.
In the Nature commentary, the authors argue that the services provided by these informal providers can and must be improved. Recognizing that health markets represent complex adaptive systems, they argue that bringing order to unregulated markets will take more than singular interventions. Indeed, a recent book published by FHS Bangladesh, Doctoring the Village Doctors: Giving Attention Where it is Due, provides a candid reflection of the difficulties they experienced in trying to improve the services of these village doctors.