The possibility to use mobile phones to provide affordable, effective and accessible healthcare solutions has continued to attract significant investments in the application of formal m-health schemes in Africa. However, while the formal m-health schemes in Africa are limited and benefited only a handful of people, a majority of individuals are using their own phones to create an informal m-health ecosystem in an attempt to bridge primary healthcare access gaps. This paper draws on qualitative data from a four-year (2012-2016) anthropological study involving marginalised groups in Sierra Leone to document these health-seeking practices along with the benefits and challenges they create in a complex plural health system. It argues that the informal integration of mobile phones into the plural health system offers opportunities for marginalised individuals to search and secure primary healthcare of their choices, but poor network connectivity, high out of pocket maintenance costs, low digital literacy skills, and the lack of policy to streamline and regulate the practices can promise the effectiveness of the informal m-health system. It concludes by offering suggestions for addressing these challenges in the Sierra Leone context.

使用手机提供负担得起的，有效的和可访问的医疗保健解决方案的可能性继续吸引了在非洲实施正式的m-health计划的大量投资。但是，尽管非洲的正式移动医疗计划有限，仅使少数人受益，但大多数人都在使用自己的手机创建非正式的移动医疗生态系统，以弥合主要医疗保健服务的差距。本文采用了一项为期四年（2012-2016年）的人类学研究的定性数据，该研究涉及塞拉利昂边缘化群体，以记录这些寻求健康的做法以及它们在复杂的多元卫生系统中创造的收益和挑战。它认为，将手机非正式地整合到多元医疗体系中，为边缘化人群提供了搜索和确保他们选择的基本医疗保健的机会，但网络连接性差，自付费用维护成本高，数字素养技能低以及缺乏精简和规范实践的政策可以保证非正式移动医疗系统的有效性。最后，提出了在塞拉利昂背景下应对这些挑战的建议。