Mapping the Informal Healthcare Sector in Urban Eswatini: A Scoping Review of Medicine and Practice

The informal healthcare sector is a substantial but poorly documented component of urban health systems in sub-Saharan Africa. In Eswatini, this sector is frequently accessed for various health needs, yet its structure, practices, and integration within the wider health landscape are not comprehensively mapped in the literature. This scoping review aimed to systematically map the available evidence on the informal healthcare sector in urban Eswatini. Its objectives were to describe the types of informal providers and their practices, identify the health conditions and medicines commonly involved, and synthesise reported community perspectives and utilisation patterns. The review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. A systematic search of multiple academic databases and grey literature sources was performed. Published and unpublished literature in English was considered. Retrieved data were charted and analysed thematically. The findings are presented as a narrative synthesis due to the heterogeneous and descriptive nature of the identified literature. A prominent theme was the widespread use of informal providers for childhood illnesses, chronic conditions, and antenatal care. The reported use of herbal preparations for managing HIV-related symptoms was a consistent detail, though specific prevalence data were limited. The informal healthcare sector in urban Eswatini is a diverse and integral part of the local healthcare landscape, particularly for managing specific conditions. The existing evidence base is fragmented and predominantly qualitative, underscoring a need for more systematic research to inform policy and practice. Future research should employ mixed-methods designs to better quantify utilisation and health outcomes. Policy initiatives should formally recognise the sector's role and explore practical frameworks for provider training, establishing referral linkages, and promoting safe practice standards to improve public health. Informal health sector, traditional medicine, urban health, Eswatini, scoping review, maternal health. This review provides a foundational map of the evidence on the informal healthcare sector in urban Eswatini, identifying key characteristics and gaps to guide future research and policy dialogue.