Prospects of the Role of Herbal Medicine in Achieving the Millennium

Development Goals for Health: Evidence from the Wassa Amenfi West District.

Adjei, B., Agyemang, S., and Mensah, C.M.KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY, KUMASI

2012 GHANA GEOGRAPHICAL/GHANA GEOGRAPHICAL TEACHERS ASSOCIATION CONFERENCE

KNUST, KUMASI

1-4 AUGUST 2012

Introduction

Health-related MDGs:Reduce child mortality Improve maternal healthCombat HIV/AIDS, malaria and other diseasesDevelop a global partnership for development

(Providing access to affordable essential drugs in developing countries).

The Goals seek to address the world’s most staggering health and poverty issues (UNDP, 2010).

Meeting the goals would produce a healthier, and more economically sound world.

Ghana’s health-related MDG targets are still far from being realised because of numerous problems bedevilling the health care sector.

Most households and individuals use herbal medicines, either as complementary or even first line treatment for their ailments (Lucas, 2010).

Proportion of use of herbal medicine:

80% of the world’s population, (WHO, 2003)

80% of Africans (Okigbo and Mmeka, 2006; WHO, 2002)

70% to 75% of Ghanaians(Baidoo, 2009; Darko, 2009; Abbiw, et al. 2002).

Herbal medicine is the first line of treatment for more than 60% of children with high fever resulting from malaria (WHO, 2003).

Studies and scientific tests have found several herbal preparations to be safe and effective, comparatively more readily available, affordable, culturally acceptable, and easily accessible (Buor,1993).

Problem statementThe Wassa Amenfi West is beset with problems of accessing and utilizing modern health care:

About 65% of the people live far from modern health centres (6km and 35km away).

Only 4.5% (40km) of the district’s 883.6km length of roads is tarred.

Inadequate healthcare facilities (only 14), and poor health professional staffing (44 medical staff) in the district.

Doctor-population ratio of 1:38,841 compared to national average of 1:11,929

High MMR of 757 per 100,000 live births compared to national average of 214 per 100,000 live births.

Long period observation and reconnaissance survey revealed a significant patronage of herbal medicine

OBJECTIVESPrimary objective is to find out the use of herbal medicine and the role it could play in achieving the MDGs for health by improving accessibility and affordability to healthcare.Specific objectives:

1. Analyze the extent of patronage of herbal medicine in the Amenfi West District

2. Evaluate the perceptions about the efficacy and safety of herbal medicine in relation to orthodox medicine.

3. Analyze the possibility of integrating traditional and orthodox health care systems and the prospects of achieving this.

Scope of the studyStudy is on the beliefs, perceptions and real life experiences associated with use of herbal medicine. It does not encompass the use of clinical tests on the efficacy of herbal medicine.

Concerned with the physical treatment aspects of herbal medicine, and not the spiritual.

Methodology

Study communities Manso Amenfi, Hiawa, Achichire, Obing and Manhyia.

Sample size of 230 used, made up of 205 household members-simple random 10 orthodox medical practitioners-purposive 15 herbal medicine practitioners-snowball sampling

Data Collection Tools Structured interviews (household members and HMPs) Questionnaires for (OMPs) FGDs Guide (cross-section of household members)

Analysis and Presentation of Data Descriptive analysis using SPSS v 16 and Excel 2007.

Frequency tables, cross tabulations, and pie charts used to present the data.

Theme analysis, non-tabular presentation and direct quotations used for qualitative data.

Results and Discussions

Extent of Patronage of Herbal Medicine Over 92% of household members have used herbal medicine at

least once in their lifetime.

All the 10 orthodox health care professionals have used herbal medicine at one point or another in their life.

Over half (50.7%) of the household members usually use herbal medicine when they are sick and 50.2% used herbal medicine the last time they were sick.

Herbal medicine is mostly used as the first choice treatment of ailments for almost half (49.7%) of the respondents, while others use it as alternative (24.9%) and complementary (21%) to orthodox medicine.

Sources of Herbal Medicine Relatives - 32.7% Farm or backyard - 30.6% Herbal practitioners 26.1% Pharmacy shops or drug stores - 6.6% Hospital or clinic - 2.9%

ICSD, UG, ACCRA 10

Herbal medicines and diseases treatedLocal name Common

nameScientific name

Part of plant used

Disease(s) treated

Onyina Ceiba pentandra

Bark Hernia

Ananse ntentan

Newbouldia laevis

Leaves Bone fracture

Mmaakube Fan palm Baassus Aethiopum

Roots Asthma

Abe Palm tree Elaeis guineensis

Oil Skin rashes

Peterprebi Gardenia ternifolia

Roots Infertility, Rheumatism

Nim, Gyedua Neem tree Azadirachta indica

leaves Fever, malaria, ringworm, etc.

Esro wisa Ashanti Pepper Piper guineesis Seed Convulsion stomach purgative

Perception on the Efficacy of Herbal Medicine

95.6% perceived herbal medicine to be effective

63.9% believed that herbal medicine is more effective than orthodox medicine.

9 of the 10 orthodox health care professionals believed in the efficacy of herbal medicine.

72.7% disagreed with the statement that herbal medicine is dangerous to human health

Reasons for disagreeing Natural - 56.7% Relatively longer life - 30% Experienced no side effects - 13.3%

A farmer in the men focus group:“I do not think this is true at all. Our forefathers depended on herbal medicine only, which is made by God (natural) and they lived longer than the current generation who mostly rely on orthodox medicine.”

Very safe45.4%

Safe37.6%

Somehow safe

13.7%

Very unsafe3.4%

Reasons for use of Herbal Medicine

Source: Field study, 2011

A teacher from the formally educated focus group had this to say: ‘’... I think herbal medicines are cheaper. For instance, I pay GHC2.OO

for only malaria injection ... Meanwhile I can boil some tea leaves and the bark of Neem tree and drink without paying for it’’

Reason Frequency Percentage (%)

More effective 90 44

Less costly 51 25

Easily accessible 47 22.8

In line with tradition 11 5.4

Other 6 2.7

Total 205 100

Interactions between Herbal Practitioners and Orthodox Medical

Practitioners93.7% of households have never been referred

from a biomedical doctor to herbal practitioner

86.3% have never been referred by a herbal practitioner to a biomedical doctor.

14 out of 15 HPs confirmed patients have never been referred from the hospital or biomedical doctor to them.

6 out of 10 Orthodox health care professionals revealed same.

Integration of Traditional Medicine into Modern Medicine

Integration is supported by: 81.5% of household members. 7 of the 10 orthodox health care professionals. 14 of the 15 herbal practitioners. Benefits of integration

Benefits of integration• Address problems of health care delivery• long distances• Queues• inadequate health professionals and logistics• Improved accessibility to healthcare • Increased health care provision,

“I think integration could be quite helpful. The reason is that where the medical doctor cannot treat an ailment, it could be transferred (referred) to the herbal practitioner…This is what we want for our people so that we will not join long queues at the hospital.”- Trader.

ConclusionHerbal medicine is highly patronized by the people of

Wassa Amenfi West and Ghanaians are developing more interest in it.

HM plays a significant role in health care delivery by providing a readily available and accessible, equally effective, and more affordable health care for the rural people.

There is strong belief in the efficacy, potency and safety of herbal medicinal plants.

Traditional and modern medicines lie side by side and not properly integrated.

Integration of both medical systems is hugely supported by all stakeholders.

Integration could go a long way in meeting the health-related goals of the MDGs.

Ways to achieve integration Promotion of cross referral of patientsEstablishment of herbal care units at all

levels of healthcare. Training of herbal practitioners in modern

health care practicesClinical testing of the efficacy and safety of

herbal medicines before useDocumentation of herbal medicines and their

usesTraining of Herbal Practitioners Dosage and side effects, Branding and packaging, Hygienic preparation and administration, Revelation of indigenous knowledge, and the Sustainable utilization of medicinal plants

Areas for further researchSeeming mistrust between herbal

and orthodox practitioners Types of plants and the parts used

for medicine.The documentation of plants and

their therapeutic properties

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