A Comparative Study of Key Empirical Issues in African Medicine: A Gambian Case Study

African medicine comprises a complex landscape of traditional and biomedical systems. Analysing the empirical issues within this context is necessary for developing effective health policies. The Gambia provides a pertinent case for examining these issues within a specific national framework. This study aimed to identify and comparatively analyse the key empirical issues characterising the practice and integration of African medicine in The Gambia. It sought to delineate persistent challenges and evolving dynamics within the health sector. A comparative, qualitative study was conducted using a multi-method approach. Data were gathered through in-depth interviews with traditional practitioners and biomedical healthcare workers, focus group discussions with community members, and a review of relevant policy documents. Thematic analysis was used to identify and compare core issues. The analysis identified several dominant themes. A primary finding was the reported high utilisation of traditional medicine for specific conditions, particularly for antenatal care and childhood illnesses. Key comparative issues included challenges in regulatory frameworks, perceived efficacy for certain ailments, and persistent barriers to formal collaboration between the two healthcare systems. African medicine in The Gambia is characterised by a distinct set of empirical issues centred on utilisation, regulation, and integration. These findings illustrate a dual healthcare system where both collaboration and tension coexist. Recommendations include strengthening the empirical evidence base for traditional practices, developing clear protocols for inter-practitioner referral, and reforming policy to foster structured dialogue and integration between the medical systems. African medicine, traditional medicine, health systems integration, The Gambia, comparative study, empirical issues This study provides a structured, empirical analysis of contemporary issues in Gambian African medicine, offering evidence to inform national policy on integration and collaborative practice.