title: Use of traditional medicine in middle-income countries: a WHO-SAGE study.
abstract: It is frequently stated in the scientific literature, official reports and the press that 80% of Asian and African populations use traditional medicine (TM) to meet their healthcare needs; however, this statistic was first reported in 1983. This study aimed to update knowledge of the prevalence of TM use and the characteristics of those who access it, to inform health policy-makers as countries seek to fulfil the WHO TM strategy 2014-23 and harness TM for population health. Prevalence of reported use of TM was studied in 35 334 participants of the WHO-SAGE, surveyed 2007-10. TM users were compared with users of modern healthcare in univariate and multivariate analyses. Characteristics examined included age, sex, geography (urban/rural), income quintile, education, self-reported health and presence of specific chronic conditions. This study found TM use was highest in India, 11.7% of people reported that their most frequent source of care during the previous 3 years was TM; 19.0% reported TM use in the previous 12 months. In contrast <3% reported TM as their most frequent source of care in China, Ghana, Mexico, Russia and South Africa; and <2% reported using TM in the previous year in Ghana, Mexico, Russia and South Africa. In univariate analyses, poorer, less educated and rural participants were more likely to be TM-users. In the China multivariate analysis, rurality, poor self-reported health and presence of arthritis were associated with TM use; whereas diagnosed diabetes, hypertension and cataracts were less prevalent in TM users. In Ghana and India, lower income, depression and hypertension were associated with TM use. In conclusion, TM use is less frequent than commonly reported. It may be unnecessary, and perhaps futile, to seek to employ TM for population health needs when populations are increasingly using modern medicine.
authors.affiliation: University of Warwick Medical School, Gibbet Hill Campus, Coventry CV4 7AL, UK o.r.o.oyebode@warwick.ac.uk.
authors.forename: Oyinlola
authors.initials: O
authors.lastname: Oyebode
authors.affiliation: Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK and Health Economics and Evidence Synthesis Research Unit, Department of Population health Luxembourg Institute of Health, Strassen, Luxembourg.
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
authors.affiliation: University of Warwick Medical School, Gibbet Hill Campus, Coventry CV4 7AL, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Chilton
authors.affiliation: University of Warwick Medical School, Gibbet Hill Campus, Coventry CV4 7AL, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lilford
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003906:Developing Countries; D005260:Female; D006291:Health Policy; D006306:Health Surveys; D006801:Humans; D008297:Male; D008519:Medicine, Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D012424:Rural Population; D012959:Socioeconomic Factors; D014944:World Health Organization
keywords: Medicine; World Health Organization; developing countries; health policy; traditional