Unfree markets: Socially embedded informal health providers in northern Karnataka, India

► In Koppal, Karnataka, India, informal providers work in markets free from regulation but embedded in social relations. ► Informal provider training and referral depend on formal government and private providers. ► Informal providers seek social protection by currying political favour from elites. ► Communities can contest informal provider expertise, delay payments, malign reputations and threaten violence. ► Quid pro quo bargains result in a fragile trust between informal providers and communities due to a lack of alternatives.