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AN ANALYSIS OF UTILIZATION OF TRADITIONAL MEDICINE IN KADUNA STATE, NIGERIA
1.0 Background to the Study
It is given that Traditional Medicine has gained increased patronage in the world over (Rainer, 2013). This study examines the utilisation of Traditional Medicine (TM) in Kaduna State of Nigeria. For those health seekers who patronise or utilize the traditional healthcare services in Kaduna State, the study examines the factors and types of health challenges that influence their decisions.. By studying the utilisation of traditional healthcare services in Kaduna State, this study provides important but rare data on the intricacies associated with its practice. Also the study unveils the challenges that emanate from the regulatory means set by the Kaduna State Government to check this informal form of medical practice and protocol in the State. The objective is to also generate data that could contribute in speaking to appropriate measures and standards that could be put in place to ensure quality and safety of Traditional Medicine practices in the State. The study also provides the baseline data for researchers for further investigations to determine the trend of utilisation and challenges faced by Traditional Medicine users in the State.
Traditional medical care services are usually provided by practitioners who are popularly referred to as Traditional Healers (THs). THs are health care providers or practitioners who typically have little or no formal or modern medical ‗training‘ from recognised medical institutions but are recognised as ‗Traditional Doctors‘ by local communities (Agbor and Naidoo, 2011).
To become a Traditional Healer, those on apprenticeship are required to acquire the skills necessary for the job. Training of would be Traditional Healers, though informal, comes in different forms and context. For instance, one of the training comes in the form of health promotion guided through food taboos in which lay down rules are developed to guide the dietary practices of people (Colding and Folke, 1997). Most teaching is done on the job while working as a learner. Through such trainings, the apprentice learns their job in exchange for continuing labour for an agreed period of time after which he or she is expected to acquire the skills to be on his/her own. This can simply be described as ―on the job training‖. This training aspect of the African Traditional Medicine prepares practitioners to be responsible, accommodating, hardworking, good listeners as well as having a sense of pride in themselves, their tradition, culture and society.
For the purpose of this study, Traditional Medicine is seen as the sum total of knowledge, skills, and practices based on indigenous theories, beliefs, and experiences passed on to present generation by preceding generations for the need of maintaining good public health, health care prevention, local health care diagnostic services and the treatment of illnesses affecting people. The sum total of the Traditional Medicine approach is therefore contextualised in the traditions of every culture which has been passed on from generation to generation. Traditional health care, therefore, connotes all health care services or medical practices that are indigenous or therapies that are non-western or non modern. In popular parlance, Traditional Medicine or traditional health care practices are conventionally regarded as non western health care practices or protocols. In this study, Traditional health care practices and Traditional Medicine is
therefore used interchangeably. The World Health Organization (WHO, 2002:1) defines Traditional Medicine as ―the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to various indigenous cultures, whether explicable or not, used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses‖.
Traditional Medicine therapies include medication which in some cases may involve the application of herbs, animal parts and/or minerals and other substances. Traditional Medicine therapies that involve non-medication or substances are usually done mainly without the use of medication. This is seen in the healing practices like acupuncture, needles used; manual therapies and spiritual therapies that are associated with warding off of evil spirits. Also, message and casting out of evil spirit.
Nations and local communities all over the world have evolved different versions of traditional medical practices for generations, and found such practices to be valuable, reasonable and still depend on them for their health care needs. Many of these nations have their own indigenous forms of health care such as yoga in India, acupuncture in China, and Native American dream catchers, amongst the indigenous population of North America (WHO, 2002a). Due to the sustainability, utility value and relevance of TM among local communities all over the world, individuals continue to utilise Traditional Medicine. This reality is partly and primarily responsible for why Traditional Medicine has continued to be complementary sources of health care to modern medical practices.
According to Rainer (2013:1), about half of the population of Latin America uses
Traditional Medicine as primary health care. WHO (2003b) estimates that in Chile, about
71% of the population use Traditional Medicine. In the same study, 40% of people in
Colombia and about 80% in the African continent were said to have utilised Traditional
Medicine. Similarly, WHO (2011) estimated that between 70% and 95% of people in the
developing countries utilized Traditional Medicine. This report went further to state that
even people in developed countries utilize Traditional Medicine in one form or the other.
Wassie, Aragie, Taye, and Mekonnen, (2015:1) describe in graphic details the increasing
and growing global significance of Traditional Medicine in both the developing and
developed world thus:
The widespread use of TM has resulted in traditional health care becoming a lucrative, multinational business. Billions of US dollars are spent annually on traditional medicine in many developed countries. For example, in 2012, 32 billion dollars were spent in the United States of America on dietary supplements, an amount expected to increase to 60 billion dollars in 2021. The World Health Organization estimates that the global market of traditional medicine is approximately US $83 billion annually. Traditional medicines also contribute to the development of pharmaceutical treatments. As much as one-third to one-half of pharmaceutical drugs was originally derived from plants. Some prominent examples including digitalis, morphine, quinine, and vinca alkaloids were obtained from plant sources.
The foregoing significance and evidence of the global use and utilisation of Traditional
Medicine further validates the earlier Alma-Ata Declaration of 1978 on Primary Health
Care, which recognises the role of Traditional Medicine and its practitioners for attaining
health for all (WHO, 1978). The declaration urges member countries to include
Traditional Medical Practitioners (TMP's) who are duly trained to work as a health team
and to respond to the expressed needs of the community.
Non-western medicine that has wide spread use and utilisation, is known in different countries by different names. For example, in the countries of Asia such as India, medicine is generally referred to as ―Indian system of medicine‖; it is indigenous to the Indian subcontinent and is a mix of six different forms of medicine currently designated with an acronym called AYUSH which stands for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (Samal, 2016: 91). In the case of China, it is refered to as Acupuncture; in North America, it is popularly referred to as Complementary and Alternative Medicine, Chiropractic, Homeopathy, (Robinson and Zhang, 2011; Abodunrin, Omojasola, Rojugbokan, 2011). In Nigeria, it is referred to as ―Traditional or herbal Medicines‖ (Awodele, Amagon, Wannang, & Aguiyi, 2014; Moreira et al. 2014). Others refer to it as ―Magic medicine‖, (Abbott, 2014, Raphael:
2011), and ―Alternative Therapies in Health and Medicine‖ (Barrett, Kiefer, & Rabago:
A number of factors which are responsible for the widespread use of Traditional Medicine have also prompted the sudden concern and need to study the rate of utilisation of Traditional Medicine across the world. For instance, Dada, Yunusa and Giwa (2011) established that Traditional Medicine enjoys high patronage and confidence from the communities where it exists because of its relevance to health issues. Abdullahi (2011:119) shares this view and went further to posit that ―Traditional Medicine is more accessible, readily available and affordable than modern drugs and therefore enjoy higher patronages from people‖. Other reasons adduced for increase in the utilisation of Traditional Medicine rests on the fact that modern medical care is increasingly becoming expensive and out of the reach of majority of the population particularly in the rural areas
of developing societies. Closely related to the foregoing is the fact that Traditional
Healers are also known to charge based on ability to pay and terms of payment are
flexible. This runs contrary to modern health system and facilities who will always insist
on cash payment before treatment (Nxumalo, Alaba, Harris, Cherisch, Goodge, 2011).
Related factors include the fact that a number of Traditional Medicines are
important and possess effective therapeutic regimens in the management of a wide
spectrum of diseases some of which may not be effectively managed using Modern
Medicine. According to Mander, Ntuli, Diederichs, and Mavundla (2007:190) that among
South African black population, Traditional Medicine ―is thought to be desirable and
necessary for treating a range of health problems that Modern Medicine does not treat
adequately‖. In Nigeria, effective medicinal plants in the management of a range of
diseases have been adequately documented (Blench and Dendo 2006; Ogunshe, Lawal
and Iheakanwa 2008) including those used for the treatment of opportunistic infections
associated with HIV/AIDS. These yet to be proved claims, as reported by Kajuna (2009)
has led researchers in Nigeria and other countries to conduct further research on
Traditional Medicine used for the treatment of malaria, HIV/AIDS, diabetes, sickle-cell
anaemia, and hypertension in order to assess their safety and objective therapeutic
1.1 Statement of the Research Problem
Scholarly studies on Traditional Medicine patronage and utilisation such as Oluwabamide (2007); Fakeye, et al., (2009) and Lucas (2010) revealed that Traditional Medicine is assuming greater importance in both primary and secondary levels of health care for individuals and communities in the developing world. An earlier study conducted by WHO (2003a) suggests that compared to Modern Medicine, Traditional Medicine seemed to enjoy a wider acceptability among the people as an estimated 80% of Africans
use it when they needed primary health care. Specifically, in Nigeria, Owumi and Taiwo (2012) aver that the Nigerian Primary Health Care is catering for less than 20% of potential patients, while Traditional Medicine caters for between 70 and 80 percent of various categories of Nigerians for the prevention, diagnosis and treatment of social, mental and physical ailments. Given the foregoing reality, the place of Traditional Medicine in health care in Nigeria and Kaduna State in particular requires a detailed investigation to ascertain the rate and extent of utilization by potential clients. This traditional health care has suffered relative neglect not only by Nigeria‘s national development planning architecture over the years, but by the nation‘s health care system development policies.