|Year : 2016 | Volume
| Issue : 4 | Page : 253-256
Toward integration of herbalism into orthodox medical practice: Perception of herbalists in Sokoto Northwest Nigeria
Muhammad Tukur Umar1, Abdulgafar Olayiwola Jimoh1, Isah Balarabe Adamu2, Adamu Ahmed Adamu1, Abdulmajeed Yunusa1
1 Department of Pharmacology and Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
2 Department of Community Medicine, College of Health Sciences, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
|Date of Web Publication||15-Nov-2016|
Dr. Muhammad Tukur Umar
Department of Pharmacology and Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto
Source of Support: None, Conflict of Interest: None
Background: Integrative system of health-care widens the horizon of health-care services where both allopathic and complementary and alternative medicine (CAM) practitioners play complementary role and make services more accessible, affordable, and safety monitoring is ensured. Objective: The objective of this study is to assess perception of herbalists on allopathic medicine and doctors. Settings and Design: The survey was carried out within Sokoto metropolis. Health services of the community were provided by a teaching hospital, 5 secondary levels hospitals and a host of primary health-care centers coupled with CAM. Herbalists were located mainly within the city located in 'Yarmarna, behind Maryam Abacha Children and Women Hospital and Kara herbs markets in the metropolis where they hawked herbs. This was a cross-sectional descriptive. Methods: Validated semi-structured interviewer-administered questionnaires were used to obtain information from the respondents. A sample of 92 herbalists was selected by multistage sampling technique. Selection of actual respondents who participated in the study was by proportionate allocation along the three major herbal centers. Results and Conclusion: The mean age of respondents was 53.1 ± 1.8 years. The mean age of years of experience in practice was 29.04 ± 1.7. On relationship with orthodox doctors, 50% admitted that it was poor while the remaining 19.6% and 30.4% described it as good and very good, respectively. More than 85% support integration of herbalism into orthodox medicine (95% confidence interval 3.67-12.12). The respondents expressed their enthusiasm to be integrated.
Keywords: Herbalists, integration, orthodox medical practice and Nigeria
|How to cite this article:|
Umar MT, Jimoh AO, Adamu IB, Adamu AA, Yunusa A. Toward integration of herbalism into orthodox medical practice: Perception of herbalists in Sokoto Northwest Nigeria. Int J Health Allied Sci 2016;5:253-6
|How to cite this URL:|
Umar MT, Jimoh AO, Adamu IB, Adamu AA, Yunusa A. Toward integration of herbalism into orthodox medical practice: Perception of herbalists in Sokoto Northwest Nigeria. Int J Health Allied Sci [serial online] 2016 [cited 2020 Jul 16];5:253-6. Available from: http://www.ijhas.in/text.asp?2016/5/4/253/194128
| Introduction|| |
Herbal medicines refer to herbs, herbal materials, herbal preparations, and finished herbal products that contained as active ingredients parts of plants, or other plant materials, or combinations thereof. Plants, on the other hand, constituted vital sources of active ingredients with therapeutic potentials that are used to cure a variety of diseases in humans., Use of herbs for medicinal therapy dates back to the history of humanity and cuts across communities globally. In Turkey, herbalism accounts for 63% of complementary and alternative medicine (CAM) usage and in Nigeria about 52% of the populace use traditional remedies for healthcare requirements. The current heave for herbal medicine globally is due to perceived increased safety, accessibility, cost and effectiveness.
The World Health Organization (WHO) reported that about 80% of the population in the developing countries depends on the traditional medicines (TMs) for their primary health-care needs. This concern prompted the WHO to encourage the integration of the TM and CAM into the health-care system of member countries. Based on this goal, countries were classified into integrative, inclusive, and tolerative. In integrative system, TM is formally recognized and fully incorporated into all the tiers of health-care system and runs hand in hand with allopathic medical practice. Notable countries in this category are people republic of China, Vietnam, and Korea. Nigeria, on the other hand, is in an inclusive category where TM is recognized but not fully integrated into the health system of the country. However, concerted efforts are underway to make Nigeria attain an integrative class.
The bill for official recognition of TM by the federal government is in the national assembly the legislative arm of government for the second reading. Nigeria was estimated to have lost about $100 billion to global herbal medicine drug markets.
| Methods|| |
The study was cross-sectional, descriptive in design aimed at assessing the perception of herbalists toward allopathic medicine and doctors in Sokoto. These included those who only sell herbs without necessarily knowing what they are used for and those who make diagnosis, prescriptions and sell herbs and herbs preparations.
The survey was carried out within Sokoto metropolis with a population of 436,698. Orthodox health services of the populace were met by a teaching hospital, 5 secondary levels hospitals and a host of primary health-care centers. The respondents recruited for the study were drawn from three main herbs markets located in 'Yarmarna, behind Maryam Abacha children and women hospital and Kara areas in the metropolis where they hawked herbs. These centers were located within the heart of the city, and therefore accessibility by the buyers was never a problem. In terms of administrative set-up, the herbalists had a central chain of command structures where each of the center is headed by a branch chairman but answerable to the state chairman.
Study population, sampling, and eligibility criteria
The study population involved all the herbalists that registered with their association body as duly confirmed by their registry. A sample of 92 out of 560 herbalists was selected by multi stage sampling technique. Selection of actual respondents who participated in the study was by proportionate allocation along the three major centers. Community entry was sought from the state chairman and subsequent introduction to each head of the center involved in the study. Participants' expressed consents were obtained before administration of the questionnaires. Only those who expressed their willingness to participate were recruited.
Instrument and data collection
Semi-structured interviewer-administered questionnaires were used to obtain information on demographic profiles and herbalists' perceptions on orthodox medicine and doctors in the study area. The questionnaire was divided into three sections. Section A contained demographic features of the respondents, section B bordered on their opinions on orthodox medicine and doctors while section C was for free comments on issues not addressed in the questionnaire. The questionnaire was reviewed for content and construct validity by experts before a pilot study was carried out in 'Yar Akija herbs centre. The piloting site and participants were excluded from the main study to avoid bias. Six research assistants were recruited to administer the questionnaires. They were fully trained on various components of the study. The questionnaires were administered at the respondents' places of practices.
The data generated were analyzed using GraphPad InStat Inc. (San Digeon, USA) for proportions, odds, and confidence intervals at 95%
| Results|| |
The mean age of respondents was 53.1 ± 1.8 years with the age range of 25-75 years. Majority of the respondents were males (87%), all were Muslims and 93.5% married. Seventy percent had no exposure to western education. Hausas constituted the majority 80.5% while Fulani, Yoruba and Zabarma 6.5% each. On the mode of skills acquisition, 95.7% of the respondents got it through heritage while the remaining by apprenticeship. Apart from herbalism, 76.1% were farmers and the rest engaged in one form of trading or another. The mean age of years of experience in practice was 29.04 ± 1.7. On relationship with orthodox doctors, 50% admitted that it was poor while the remaining 19.6% and 30.4% described it as good and very good, respectively.
| Discussion|| |
This survey revealed low formal education level of herbalists which was similar to the finding in Lebanon. This may affect the quality of herbal preparations they sold and would go further in strengthening the skepticism being expressed especially as regards to safety. This is particularly worrisome if they were to be integrated in orthodox medicine despite the fact that majority support being incorporated. The poor quality of relationship with orthodox doctors observed in this study was closer to what was reported in Australia. The finding of this study on the opinion of respondents on integrating herbalism into orthodox medicine is close to 82.4% documented by a similar study in Israel. However, it differed from what was reported by. Collaboration of orthodox doctors with traditional health practitioners was reported to reduce malaria mortality rate from 5% to 2% and treatment of severe malaria from 58% to 10% in Mali [Table 1]. The observation in this study on the integration was quite higher than what was documented in studies where opinions of orthodox doctors were sought on same integration 45, 90.9 and 30%.,, That was quite encouraging and elucidated the fact that with proper national health policy on CAM of which herbalism was the most practiced could successfully be incorporated into the national health scheme [Table 1]. On whether the respondents regarded orthodox medicine as important in health-care delivery, a very good number admitted in affirmative [Table 1]. This finding reechoed the observations made by previous sister studies that sought the views of orthodox doctors on the relevance of CAM in health-care delivery [Table 1]., These findings were interesting as they contrasted earlier report by where herbalism (CAM) was viewed with skepticism and disdain. This was reassuring and may serve as a strong impetus towards the much-awaited integration. Majority of the respondents agreed to share their knowledge of herbs with orthodox doctors. This is a major milestone towards integration as previous studies suggested otherwise to preserve culture [Table 1]. Agreeing to share their knowledge of herbs, will broaden the scope of drugs discovery as a considerable number of drugs used in orthodox medicine are plants derived. It will also decrease to the barest minimum the suspicion held by the herbalists on domination by orthodox doctors. This may also minimize adulteration of herbal preparations with orthodox drugs to enhance efficacy as well as averting potential toxic, drug-herbs interactions which in most cases were missed by orthodox doctors. It is interesting to observe that majority of the respondents refer their patients/clients to orthodox health facilities [Table 1].
This finding is in support of similar findings.,, This demonstrated the level of the confidence reposed in orthodox medical care by the herbalists on one hand and awareness of their limitations on the other. With continued meaningful engagement, the apparent barrier between orthodox medical practice and CAM (herbalism) may be bridged. On the awareness of the agency saddled with the responsibility for registering and monitoring of drugs administration was really disturbing [Table 1].
This showed the need for more attention to CAM practitioners more so that about 80% of the populace in developing nations like Nigeria depends on CAM for their basic health-care needs.
| Conclusion|| |
The index study has shown the willingness of the respondents' to share their knowledge of herbs with orthodox medical practitioners and also be actively involved in the integration process. However, there is need for more targeted intervention to enlighten herbalists on need to regulate their practices.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Gill NS, Sharma P, Bajwa J, Dhiman K, Sood S, Sharma PD, et al.
Study on Cucumis melo
var. Utilissimus seeds for the therapeutic potential. J Plant Sci 2010;5:248-55.
Gill NS, Bajwa J, Dhiman K, Sharma P, Sood S, Sharma PD, et al.
Evaluation of therapeutic potential of traditionally consumed Cucumis melo
seeds. Asian J Plant Sci 2011;10:86-91.
Ozer O, Santas F, Yildirim HH. An evaluation on levels of knowledge, attitude and behavior of people at 65 years and above about alternative medicine living in Ankara. Afr J Tradit Complement Altern Med 2012;10:134-41.
Jane-Lovena EO, Onyiapat I, Okoronko L, Ngozi PO. CAM use among adults in Enugu in Nigeria. BMC 2011;11:19.
Moody JO. Traditional Medicine. Paper Delivered at the Mandatory Continuing Professional Development (MCPD); 2007.
Osemene KP, Elujoba AA, Ilori MO. A comparative assessment of herbal and orthodox medicines in Nigeria. Research J Med Sci 2011;5:280-5.
National Population Commission-Legal Notice on Publication of 2006 Census- Final Policy and Legal. Available from: http://www.population.gov.ng
. [Last accessed on 2015 Jan 15].
Taha D, Khouzama K, Zabta KS, Sawsan K, Elias B. Survey of medicinal plants currently used by herbalists in Lebanon. Pak J Bot 2013;45:543-55.
Abdulgafar OJ, Abdulfatai TB. Safety perception and knowledge of commonly used complementary and alternative medicine among physicians in UDUTH Sokoto, Northwest Nigeria. Sahel Med J 2014;17:140-4.
Casey M, Adams J, Sibbritt D. An examination of the clinical practices and perceptions of professional herbalists providing patient care concurrently with conventional medical practice in Australia. Complement Ther Med 2008;16:228-32.
Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients, physicians and complementary practitioners. Patient Educ Couns 2008;70:395-402.
John KO, Peter AM, Frimpong W. Traditional and modern medicine: A survey of views on its integration in Ghana. Int J Afr Soc Cult Trad 2015;3:22-36.
Diallo D, Koumara M, Traore AK, Sanogo R, Coulibaly D. Collaboration between traditional health practitioners and conventional health practitioners the Malian experience: Traditional medicine our culture our future. Afr Health Monit 2003;4:35-6.
Alrashidi FE, Sarkhou NW, Alotaibi MS. Knowledge and attitude of CAM among general practitioners in Farwaniya Health Region Kuwait. Greener J Med Sci 2013;3:79-84.
Oyelakin RT. Yoruba traditional medicine and the challenge of integration. J Pan Afr Stud 2009;3:73-85.
Falodun A. Herbal medicine in Africa distribution, standardisation and prospects. Res J Phytochem 2010;4:154-61.
Cottingham P, Adams J, Vempati R, Dunn J, Sibbritt D. The characteristics, experiences and perceptions of naturopathic and herbal medicine practitioners: Results from a national survey in New Zealand. BMC Complement Altern Med 2015;15:114.
Gyasi RM, Mensah CM, Adjei PO, Agyenmang S. Public perceptions of the role of traditional medicine in the health care delivery system in Ghana. Glob J Health Sci 2011;3:40-9.