By Dr Oyinlola Oyebode
Associate Professor of Public Health, Warwick Medical School
As is widely documented in the scientific literature, official fact sheets, reports and the press, 80% of people in Asian and African countries (or sometimes that 80% of the world’s population) use traditional medicine practitioners to meet their primary healthcare needs. This statistic has also been used in policy-making and in defence of traditional, complementary and alternative medicine.
However, in some low- and middle-income countries, the number of medically qualified doctors, nurses and the resources needed for a fully functional modern health care service may be insufficient to meet the health care needs of the population. Where this occurs, traditional medicine and its practitioners are considered an important resource for population health. Compared to modern medicine, traditional medicine is perceived, by many, to be more affordable, accessible and acceptable to the communities in which it operates.
In the course of pursuing research examining the use of traditional medicine, I became aware that a substantially lower percentage of people report accessing it, than the 80% commonly quoted (at least in the data source I was using). At first I thought there must be something wrong with the data (representative survey data collected by the WHO from 6 middle-income countries). Once I started to investigate this further I found that there were other sources that corroborated my findings. I also found a blog post that traced the 80% statistic and found that it is likely to have originated in a World Health Organisation (WHO) textbook published in 1983, with the original data on which it was based now lost.
When my team at Warwick Medical School analysed the survey data, we found that of the countries examined, use of traditional medicine was reported most frequently in India, where 11.7% of people reported that they most often approached a traditional healer when they needed care, over the past 3 years. Less than 3% reported that their most frequent source of care was a traditional healer in China, Ghana, Mexico, Russia and South Africa. When asked about health care use in the last 12 months, 19% of participants in India said they had consulted a traditional healer; compared to 9.4% of the participants in China. In Ghana, Mexico, Russia and South Africa this statistic was less than 2%.
In our research we were only able to examine 6 middle-income countries (of which just 4 were in Asia and Africa) and it is possible that the survey wasn’t able to identify all the use of traditional medicine (perhaps because participants didn’t admit using traditional healers in order to appear progressive, i.e. social desirability bias). Outstanding research questions include: What percentage of people rely on traditional medicine in low income countries and other middle income countries? For those users of traditional medicine, is this a second-best option when modern medicine is unavailable or is it the option of choice for some people or for specific medical conditions?
Integration of traditional medicine and modern medicine has been recommended by the WHO since 1978. The recently published WHO Traditional Medicine Strategy 2014–23 has two key goals, one of which is to support Member States in harnessing the potential contribution of traditional and complementary medicine to health, wellness and people-centred health care. This policy position, based on an assumption of widespread use of traditional medicine, may need revision if it is found that use of traditional medicine is low and/or declining, especially when there are reasons to doubt its effectiveness (and even its safety) in comparison to modern medicine.
To see the published paper reporting our findings click here.