Informal Healthcare Provision and Maternal Medicine in Urban Guinea-Bissau: A Working Paper

In many urban African settings, under-resourced formal healthcare systems lead to a reliance on informal providers for maternal health needs. The nature and implications of this sector for maternal medicine are poorly documented in Guinea-Bissau. This working paper aims to map and characterise the informal healthcare landscape providing maternal medicine in urban Guinea-Bissau. It seeks to understand the types of providers involved, the medicines they supply, and the reasons pregnant women and new mothers use these services. This qualitative study employed ethnographic methods, including semi-structured interviews and informal conversations with informal providers, pregnant women, and community members in a major urban area. Observations were conducted at informal points of sale and consultation. Informal provision is widespread and includes market vendors, traditional birth attendants, and informal drug sellers. A prominent theme is the provision of medicines for labour augmentation and postpartum recovery, often without prescription. A substantial proportion of interviewed women reported using such services, citing accessibility, cost, and perceived cultural congruence as primary reasons. Informal healthcare providers constitute a significant, embedded part of the maternal healthcare ecosystem in urban Guinea-Bissau, particularly for medicinal needs. Their practices intersect with, and sometimes circumvent, formal pharmaceutical regulations, presenting both risks and a pragmatic adaptation to systemic gaps. Future research should quantify the scale and safety of specific medicinal practices. Engagement strategies between formal and informal sectors should be explored to mitigate risks while acknowledging the sector's role. Regulatory frameworks require review to address the realities of informal medicine provision. Informal healthcare, maternal health, pharmaceuticals, urban Africa, Guinea-Bissau, qualitative research This working paper provides a foundational, descriptive analysis of informal maternal medicine provision in an under-studied context, offering initial evidence for policy and further investigation.