Community leaders’ perspectives on linking formal and informal health providers in Nigerian urban slums: a qualitative study

Informal health providers (IHPs) often dominate health service provision in urban slums in Nigeria. For the CHORUS project on developing linkages between informal and formal healthcare to improve equitable health service provision, the HPRG team (University of Nigeria) explored the capacity of leaders within slums to contribute to linkage development, through interviews with 16 community leaders across 8 urban slums in Enugu and Anambra states in Southeast Nigeria.

The research highlights how chairpersons and local vigilante security outfits are ubiquitous across urban slum communities- coordinating and influencing actors and health activities within settlements. Oversight functions and lived experiences meant leaders had a good insight into existing community dynamics. Slum leaders acknowledged the differential roles, as well as the strengths and weaknesses of FHPs and IHPs. Linkage establishment was considered potentially useful, and leaders were willing to assist, if the existing shortcomings in FHPs were addressed. The research emphasises that leaders in urban slums have the potential to help the realisation of health goals given their grassroots influences. Community leaders in urban slums have strategic positional knowledge and leverage that could catalyse the IHP-FHP linkage conversation and implementation towards improving access to quality healthcare services in slums.

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Okechi, B., Orjiakor, C.T., Nwokolo, C. et al. Discov Soc Sci Health 5, 61 (2025).