ASSESSING THE LEVEL OF KNOWLEDGE AND UTILIZATION OF TRADITIONAL MEDICINE AMONG THE COMMUNITY

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Traditional medicine is considered to be culturally acceptable, less harmful, and a more natural form of medicine that is suitable with the human body system (Espinal et al., 2020). It is estimated that 75–80 percent of the world's population uses traditional medicine as their primary source of healthcare, and this use is most prevalent in developing countries (Maartens, 2018). People who practise self-care and are actively involved in their own health care are increasingly turning to the use of traditional medicines as a traditional therapy (Jackson, 2021). The prevalence of a belief in complementary and alternative medicine (CAM) in Nigeria contributed to an increase in the use of traditional remedies as a form of self-care for disease (Jasmer, 2015). In underdeveloped nations, the vast majority of the population adheres to the view that the use of traditional remedies for the treatment of a variety of disorders is effective. The notion that all traditional medicines are safe and natural alternatives to conventional medications has contributed to the growth in the use of traditional medicines either on their own or in combination with allopathic treatments (Adepoju, 2020). This trend may be seen either in the United Kingdom or in the United States.

However, because herbs are considered medications, it is reasonable to predict that they will have some unpleasant side effects (Kursar, 2019). These drugs are sold in health food stores, despite the fact that they are illegal in a number of nations. In Nigeria, the National Agency for Food and Drug Administration and Control (NAFDAC) has approved the sale of a number of traditional medicines, even though an investigation into the comprehensive evaluation of the medicines' risk profiles is still underway (Kursar, 2019). Both the impression of NAFDAC and the unfettered advertising of these items are major causes to the surge in the use of traditional medicines (Rees & Murray, 2017). traditional medicine has been considered to be particularly prevalent in Africa for a long time, and a sizeable portion of the continent's population relies on it to maintain their health, as well as to prevent and treat both communicable and non-communicable diseases. Africa is one of the regions of the world in which traditional medicine is considered to be widespread (Jackson, 2021). The attention of policy leaders, researchers, and healthcare professionals has recently been drawn to the growing use of traditional medicine across the continent in recent decades. In the past two decades, the World Health Organization (WHO, 2015) cited in  (Morkve, 2017) regional office for Africa has been at the forefront of driving forward the implementation of a regional strategy to promote the use of traditional medicine within African health care systems. This strategy was ratified by African heads of state in the city of Lusaka, Zambia. The approval of the regional plan has resulted in a number of positive outcomes, including the formulation of policies in thirty-six countries and the encouragement of research, which has led to the development of TCAM research centres in some nations, such as Nigeria, Ghana, and South Africa (Kheir, 2016). The regional strategy has also encouraged the incorporation of TCAM courses into the curricula of healthcare training institutions across the continent. These institutions may be found in a variety of nations across the continent  (Morkve, 2017).

The consistent increase in the frequency of chronic non-communicable illnesses is considerably contributing to Africa's disease burden, and it is adding stress to healthcare systems that are already stretched to their limits due to the high incidence of infectious diseases (Anderson et al., 2017). In light of the widespread use of traditional medicine for the treatment of chronic health conditions in regions of the world other than Africa, it is reasonable to hypothesise that traditional medicine will also play an important part in the health and well-being of people in Africa who are afflicted with chronic diseases. Within the context of restricted access to critical health services, particularly among the rural poor, the importance of traditional medicine in the provision of primary healthcare is acknowledged in the health policy papers of various nations in Sub-Saharan Africa. This is particularly the case in rural areas (Godfrey-Faussett and Ayles, 2017).

Around eighty percent of poor nations rely on traditional medicines for their main health care requirements, as stated by the World Health Organization (WHO, 2017), which was mentioned in Barnejee, Harris, and Nyirende (2018). Traditional medicine, and more specifically traditional medicine, plays a significant role in Nigerian people's access to modern medical treatment and overall health care. There are many different cultures and groups to be found in Nigeria, each with their own unique body of traditional knowledge on the use of traditional remedies to treat a wide range of human conditions (Maartens, 2018). The use of traditional medicine is common in Nigeria, although it varies greatly because to the country's rich cultural and floral variety. Additionally, traditional medicine has significant effects on both the country's economy and its efforts to preserve its native biodiversity (Barnejee, Harris, and Nyirende, 2018). The rich history of the usage of traditional remedies and inventive exploitation of plants as sources of medicines in Nigeria, and more generally throughout Africa, has been passed down through centuries mostly as oral tradition. As a result, it is essential that this information be preserved. 

1.2 Statement of the problem

It has been determined that community pharmacies all over the world are the primary suppliers of traditional medications (Kursar, 2019). Because of this, they have an important part to play in the consumption of traditional medicines that their customers have purchased, which is especially relevant given that these medicines are typically available for purchase without a prescription in many nations and are referred to as over-the-counter (OTC) medicines (Rai MK, 2019). In addition, customers typically consult pharmacists for recommendations and information on drugs, including traditional remedies (Stevenson et al., 2017). Previous research in Nigeria has been done on the use of traditional medicine among people suffering from a variety of chronic illnesses, pregnant women, and children who have chronic illnesses (Glynn, 2015; Kursar, 2019; (Rob, et al, 2015).

The most common justifications for using traditional medicine are that it is less expensive, that it more closely corresponds to the patient's ideology, that it allays concerns about the adverse effects of chemical (synthetic) medicines, that it satisfies a desire for more personalised health care, and that it allows the general public greater access to health information (Daniel, 2016). The most common use for traditional medications are health maintenance and treatment of ongoing problems, as opposed to emergency situations or acute illnesses. On the other hand, when contemporary medicine is unable to effectively treat a sickness, such as when cancer has reached an advanced stage or when there is a newly emerging infectious disease, people are more likely to turn to traditional treatments (Maartens, 2018). In addition, people have a general perception that traditional medicines are natural and harmless, or in other words, not poisonous. This is not always the case, particularly when herbs are taken in conjunction with prescription pharmaceuticals, over-the-counter treatments, or even other herbs, as is very frequently the case (Jackson, 2021). traditional medicine offers a vital health care service regardless of whether patients have physical or financial access to allopathic medicine, and it is a booming worldwide economic industry. This is true whether or not the individual who utilises it has access to allopathic treatment.

However, understanding the attitude and knowledge of communities about the  utilisation of traditional medicines is something that has to be assessed on a continuing basis, particularly in Nigeria, where people have little or no knowledge about the use of traditional medicines as well as unrestricted access to the practise of using traditional medicines. This study was therefore aimed at assessing the level of knowledge and utilization of traditional medicine among the community with precised focus on Nkanu East and West LGAs of Enugu State.

1.3 Research questions

These questions will guide the findings of this study;

1. What is the opinion of residents of Nkanu East and West LGAs of Enugu State about the use of traditional medicine?
2. What is the knowledge level of residents of Nkanu East and West LGAs of Enugu State about the use of traditional medicine instead of orthodox medicine?
3. Why do communities utilize traditional medicine to treat themselves?
4. What is the attitude of residents of Nkanu East and West LGAs of Enugu State towards the use of traditional medicine?

1.4 Objectives of the study

This study aims to assess the level of knowledge and utilization of traditional medicine among the community using Nkanu East and West LGAs of Enugu State. In addition, other definite objectives of this research are to;

1. Find out the opinion of residents of Nkanu East and West LGAs of Enugu State about the use of traditional medicine.
2. Find out the knowledge level of residents of Nkanu East and West LGAs of Enugu State about the use of traditional medicine instead of orthodox medicine.
3. Find out why communities utilize traditional medicine to treat themselves.
4. Find out the attitude of residents of Nkanu East and West LGAs of Enugu State towards the use of traditional medicine.

1.5 Research hypothesis

The following null hypotheses are tested in this study;

H01: The residents of Nkanu East and West LGAs of Enugu State do not utilise traditional medicine in treating themselves.

H02: The residents of Nkanu East and West LGAs of Enugu State do not have knowledge about the use of traditional medicine.

1.6 Significance of the study

Previous researchers have directly and indirectly studied the use of traditional medicines in treating different illnesses. Ideally, strong and robust findings have been made in this aspect of study, but with little focus on the level of knowledge and utilization of traditional medicine among the community. This study is therefore significant as it raises a media and environmental awareness in communities in  Nigeria in the context of the level of knowledge and utilization of traditional medicine among the community. Also, the findings of this study is a call to action for World Health Organization, Medical practitioners, etc in order to formulate and most importantly implement strategies that will begin a bridge in the gap of using traditional and orthodox medicine in treating patients, thereby creating a balance in both areas to avoid a misuse of the traditional medicine usage to limit casualties this may cause in the lives of patients. This study will also add to existing literature on this study area and shall serve as a bench mark to students, researchers and scholars who may wish to carry out further research on this topic or related domain in the future.

1.7 Scope of the study

This study aim to assess the level of knowledge and utilization of traditional medicine among the community using Nkanu East and West LGAs of Enugu State as a case study.  Nkanu East and West LGA are local government Areas in Enugu State with Enugu as its capital city, this geographical location was selected for this study because prior studies reviewed in the course of this investigation revealed no existing literature to have carried out a study on these locations in the context of assessing the level of knowledge and utilization of traditional medicine among the community.

The scope also covers the opinion of residents of Nkanu East and West LGAs of Enugu State about the use of traditional medicine, find out the knowledge level of residents of Nkanu East and West LGA of Enugu State about the use of traditional medicine instead of orthodox medicine, find out why communities utilize traditional medicine to treat themselves, and find out the attitude of residents of Nkanu East and West LGAs of Enugu State towards the use of traditional medicine. Hence, residents of Nkanu East and West Local Government Areas of Enugu State shall serve as enrolled participants for this study.

1.8 Limitation of the study

The limitations of this study are in relation to its geographical scope, That is, the area covered. Findings of this study cannot be generalized for other Local Government Areas and states in Nigeria. Also, the sample size for this study cannot be totally accepted as the true representation of facts in Nkanu East and West Local Government Areas, Enugu State. Facts presented in this study are subject to further researches.

1.9 Definition of terms

Traditional Medicine

traditional medicine in this study implies the type of medicine that uses roots, stems, leaves, flowers, or seeds of plants to improve health, prevent disease, and treat illness.

Treatment: Treatment in this study implies the medical care given to a patient for an illness or injury.

Illness: Illness in this study implies an unhealthy condition of body or mind.

Knowledge: Knowledge in this study implies the fact or condition of knowing something with familiarity gained through experience or association via the use of traditional medicine in treatment of illness.

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