A Longitudinal Analysis of Comparative Medical Practices in Gabon: A Twenty-First Century African Perspective

The integration of diverse medical practices, including traditional and biomedical systems, is common in many African healthcare contexts. In Gabon, such medical pluralism is widespread, but longitudinal evidence on its comparative use, perceived efficacy, and outcomes within maternal and gynaecological care remains scarce. This longitudinal study aimed to document and analyse patterns of comparative medical practice use for obstetrics and gynaecology in Gabon. It sought to understand patient pathways, perceived outcomes, and the factors influencing choices between traditional and biomedical healthcare over time. A prospective longitudinal cohort design was employed. A cohort of women of reproductive age was recruited from multiple community and clinical settings. Data were collected through repeated structured interviews and clinical record reviews at regular intervals. Quantitative data on healthcare choices and outcomes were analysed statistically, while qualitative data on perceptions and experiences were analysed thematically. A consistent pattern of concurrent utilisation was identified, with over 60% of participants reporting use of both biomedical and traditional services for the same health episode across multiple time points. Qualitative analysis indicated that choice was predominantly influenced by perceived illness aetiology, with chronic or culturally-defined conditions more frequently leading to traditional care-seeking. Comparative medical practice in Gabon is characterised by sustained, concurrent use rather than sequential substitution. This indicates a deeply integrated, pluralistic health system where patients navigate multiple modalities based on specific health beliefs and conditions. Policymakers and clinicians should formally acknowledge this integrated system. Training for biomedical practitioners should include cultural competency regarding traditional practices. Further research should explore frameworks for safe, collaborative practice between sectors. Comparative medicine, medical pluralism, traditional medicine, maternal health, gynaecology, longitudinal study, Gabon, healthcare utilisation This study provides longitudinal evidence on the concurrent use of medical systems in Gabon, offering insights for developing more responsive maternal and gynaecological healthcare policies that reflect actual patient behaviour and beliefs.