A Survey of Comparative Medicine Practices and Perceptions in São Tomé and Príncipe: A Regional Analysis, 2021–2026

This survey research investigates comparative medicine practices and professional perceptions within São Tomé and Príncipe (STP) from 2021 to 2026. It addresses a critical gap in regional health systems literature, as the integration of traditional, complementary, and biomedical care—a cornerstone of healthcare access across Africa—remains poorly documented in this island nation. A structured, cross-sectional survey was administered to a purposive sample of 150 registered practitioners, including physicians, nurses, and licensed traditional medicine practitioners, across all seven districts. Quantitative and qualitative data were collected on clinical practices, referral patterns, perceived efficacy, and inter-professional attitudes. Key findings demonstrate a high prevalence of collaborative practice: 82% of biomedical practitioners reported regular patient inquiries about traditional remedies, whilst 68% of traditional practitioners indicated referring patients to public health facilities for acute conditions. However, significant disparities were noted in perceptions of regulation and safety, revealing underlying tensions. The study concludes that although comparative medicine in STP is characterised by pragmatic coexistence, its systemic integration is hindered by asymmetrical professional recognition and a lack of formal dialogue platforms. These findings underscore the necessity for developing context-specific, inclusive health policies that formally acknowledge and regulate the sector. This is essential for strengthening the overall health system and achieving equitable, culturally competent healthcare delivery in STP and similar settings.