Australian researchers completed the first comprehensive and empirical study on the use of traditional, complementary, and alternative medicines (TCAM) in sub-Saharan Africa. They reported that people in that region use a significant amount of TCAMs even though they enjoy access to modern medicine and could afford the cost of conventional treatments.

“Health departments and governments across the region must acknowledge that TCAM is here to stay and seek to understand the challenges and opportunities this presents for health care,” says Peter Bai James, a doctoral candidate at the University of Technology Sydney (UTS) who served as the lead researcher and primary author or the study.

James and his colleagues evaluated 180 studies on the use of TCAM in sub-Saharan Africa between 2006 and 2017 and found that it was significantly high.

They also reported that Africans used TCAM either alone or alongside conventional medicine. In fact, the general population relied on it to treat specific health conditions, such as cancer, malaria, and pregnancy.

Use of TCAM by sub-Saharan Africans is significantly high

The UTS researchers found that, on average, almost 60 percent of the populations in four sub-Saharan countries used TCAM therapies and products. In Ethiopia and Nigeria, up to 94 percent of the population used alternative medicines.

The most widely-used TCAM in sub-Saharan Africa proved to be biological-based therapies, in particular, herbal therapy. People also preferred healing methods that relied on faith, prayer, and spirituality, as well as mind-body therapies like massage, meditation, relaxation, traditional bone setting, and yoga.

As for the reasons behind the widespread use of TCAM, the researchers enumerated low cost, alignment with the religious, sociocultural, and spiritual values of patients, and dissatisfaction with conventional health care. They also noted that TCAM users were often of low socioeconomic status and educational attainment.

Furthermore, most TCAM users preferred not to tell their health care providers about their use of alternative medicines. Some of them were afraid of getting improper care from their providers, who disapproved of TCAMs, while others said that they never got asked about it.

Compared with non-African populations, the researchers found a lower prevalence of self-reported adverse effects among sub-Saharan Africans. However, the researchers believe that this low prevalence may be due to the participants’ hesitation to disclose their use of TCAM.

“TCAM product safety regulation across Africa is still a challenge as many countries… lack adequate regulatory framework to ensure the safety and quality of TCAM,” wrote the researchers in their paper. “The systematic collection and analysis of TCAM safety data is crucial in order to protect patients and the public at large.”

Alternative medicines continue to serve as the primary means of health care in Africa

James warned that assumptions are what shaped most of the policies about the use of traditional, complementary, and alternative treatments implemented today. The World Health Organization (WHO) and many non-governmental organizations believe that people in sub-Saharan Africa rely on TCAM due to poor access to conventional medicine.

However, the results of the study indicate otherwise. They showed that improved access to conventional health services did not reduce the use of TCAM. Instead, TCAM use increased with it.

James believes that alternative medicines should not be dismissed as an afterthought when it comes to setting health policies in sub-Saharan Africa. Health departments and governments need to recognize the importance of TCAM as a major contributor to primary healthcare and look for ways to leverage them.