Toward integration of herbalism into orthodox medical practice: Perception of herbalists in Sokoto Northwest Nigeria

Muhammad Tukur Umar; Abdulgafar Olayiwola Jimoh; Isah Balarabe Adamu; Adamu Ahmed Adamu; Abdulmajeed Yunusa

doi:10.4103/2278-344X.194128

ORIGINAL ARTICLE

Year : 2016 | Volume : 5 | 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

Correspondence Address:
Dr. Muhammad Tukur Umar
Department of Pharmacology and Therapeutics, College of Health Sciences, Usmanu Danfodiyo University, Sokoto
Nigeria

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/2278-344X.194128

Abstract

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 2023 Mar 28];5:253-6. Available from: https://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.^[1] 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.^[2],[3] 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^[4] and in Nigeria about 52% of the populace use traditional remedies for healthcare requirements.^[5] The current heave for herbal medicine globally is due to perceived increased safety, accessibility, cost and effectiveness.^[6]

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.^[1] 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.^[7]

Methods

Study design

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.

Setting

The survey was carried out within Sokoto metropolis with a population of 436,698.^[8] 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.

Data analysis

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.^[9] 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.^[10] 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.^[11] 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.^[12] However, it differed from what was reported by.^[13] 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^[14] [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%.^{[10],[12],[15]} 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].^[10],[12] These findings were interesting as they contrasted earlier report by^[7] 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].^[16] 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.^[17] It is interesting to observe that majority of the respondents refer their patients/clients to orthodox health facilities [Table 1].

Table 1: Perception of respondents on orthodox medicine

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This finding is in support of similar findings.^{[11],[18],[19]} 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.^[6]

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

Nil.

Conflicts of interest

There are no conflicts of interest.

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