Ungoverned Spaces Among Informal Health Providers in Nigeria and Health Security Implications

Ungoverned spaces refer to systems that are evasive of government regulations. They manifest in health systems when health authorities struggle to regulate certain healthcare providers. The current study underscored Informal Health Providers (IHPs) such as Patent Medicine Vendors (PMVs), Herbalists, Traditional Birth Attendants (TBAs), etc., as typical of ungoverned heath spaces in Nigeria and a threat to citizens' health security. Interviews and group discussions were used to collect data from 90 participants. The findings showed some groups of IHPs without interface with government health authorities. Although PMVs and TBAs had some interface with the government, the study still found many aspects of their practices that were not governed. Unions of the IHPs could be parallel to health authorities. Indeed, IHPs can provide care in difficult contexts where formal healthcare is lacking, however, their continuous ungoverned operations could undermine citizens' rights to quality healthcare, which conflicts with the ideals of the social service workforce. Therefore, future research should focus on co-designing policies and programs that can help to pull IHPs into an effectively governed pool.