Replicating the Nexus: Informal Healthcare Provision and Maternal Health Outcomes in Urban Uganda

The informal healthcare sector is a substantial component of urban health systems in sub-Saharan Africa. Previous research indicated a significant association between the use of informal care and maternal health outcomes, but these findings required verification. This replication study aimed to verify the relationship between informal healthcare provision and maternal health outcomes in an urban Ugandan setting. The primary objective was to confirm the direction and strength of this association. A cross-sectional, mixed-methods design was employed. Quantitative data were collected using structured surveys with postpartum women at public health facilities. Qualitative data were gathered via semi-structured interviews with informal providers and focus group discussions. Analytical methods mirrored those of the original study for direct comparison. The replication confirmed a strong association between reliance on informal sector care and increased risk of adverse maternal outcomes. Women primarily using informal providers were approximately 40% more likely to experience a major complication. Qualitative data identified accessibility, cost, and perceived cultural congruence as key reasons for this reliance, despite acknowledged limitations in care quality. The study replicates the core finding of a significant link between informal healthcare use and poorer maternal health outcomes in this urban context. It highlights the informal sector's dual role as both a barrier to safe care and an entrenched source of support. Policy should move beyond condemnation. Recommendations include developing targeted regulation, creating structured referral pathways to formal services, and designing community-based health education that acknowledges the sector's role while mitigating risks. maternal health, informal health sector, replication study, urban health, Uganda, healthcare access This study provides a crucial verification of earlier evidence, strengthening the empirical basis for understanding the informal sector's impact on maternal health in urban Africa.