Dauda Ayuba¹, Precious Kehinde Fadele², Jerico B. Ogaya³, Kolawole Emmanuel Olayinka⁴, Shashikant Nishant Sharma⁵,
Don Eliseo Lucero-Prisno III^6,7,8

¹Department of Local Government and Development Studies, Ahmadu Bello University, Zaria, Nigeria

²College of Medicine, University of Nigeria, Enugu State, Nigeria

³Department of Medical Technology, Institute of Health Sciences and Nursing, Far Eastern University, Manila, Philippines

⁴Faculty of Engineering, University of Nigeria, Nsukka, Enugu, Nigeria

⁵Maulana Azad National Institute of Technology, Bhopal, PIN 462003, India

⁶Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom

⁷University of Makati, Makati, Philippines

⁸Biliran Province State University, Naval, Leyte, Philippines

Corresponding author: Dauda Ayuba, Department of Local Government and Development Studies, Ahmadu Bello University, Zaria, Nigeria

Email: daudayuba10@gmail.com

DOI: https://doi.org/10.47811/bsj.0004050304

Complementary and alternative medicine involves medical practices rooted in traditional methods such as herbal remedies and spiritual beliefs. Historical factors influence the practice of alternative medicine in Nigeria. This study examines cultural perceptions, practices, challenges, and integration strategies for alternative medicine in the Nigerian healthcare system. Nigeria, with a population of over 200 million, faces significant health challenges, necessitating robust healthcare systems. Despite having over 80,000 registered doctors, there is a low doctor-to-population ratio of 4,000 to 5,000 people per doctor. Traditional healers practicing under partial regulation significantly contribute to healthcare delivery by using indigenous herbal and spiritual therapies. Challenges in integrating alternative medicine include standardization, limited scientific evidence, stigma, funding constraints, and barriers to access of services . Integration efforts involve creating inclusive healthcare systems that combine traditional and modern approaches, prioritize equitable access, and respect for cultural diversity, developing standardized training, generating scientific evidence, and increasing public awareness. Collaboration among stakeholders, such as healers, healthcare providers, policymakers, researchers, and communities, is essential for successful integration and improved healthcare outcomes. The Nigerian healthcare system can benefit from integrating alternative medicine and promoting holistic and culturally sensitive practices. Overcoming these challenges requires cooperation, evidence-based strategies, and investments in research, leading to more effective healthcare delivery, improved health outcomes, and reduced disparities nationwide. Countries on integration journeys should prioritize collaboration, establish clear regulations, raise public awareness, and invest in research to support the effectiveness and safety of alternative medicine.

The National Centre for Complementary and Alternative Medicine defines complementary and alternative medicine as medical practices, systems, and products outside mainstream medicine [1]. Alternative medicine, including traditional methods using plants and spiritual beliefs, has been practiced for centuries, predating conventional medicine [1]. There have been centuries of traditional medical practices, with many ethnic groups having distinctive methods of healing. This method is based on the use of plants, herbs, ceremonies, and spiritual beliefs.

In Nigeria, foreign influences from colonization and the slave trade have shaped alternative medicine. It remains significant, particularly in rural areas lacking adequate healthcare [2, 3]. Complementary and alternative medicine is the oldest form of healthcare system that has lived the test of time. Alternative Medicine has been used by African communities to treat diseases long before the discovery of conventional medicine [1]. Approximately 85% of Nigerians depend on traditional medicine for various benefits [2]. This reliance is especially significant in poor communities with limited access to modern healthcare [3]. Alternative medicine’s historical roots and widespread usage underscore its importance in treating diseases and addressing health needs, especially where conventional medical resources are scarce.

According to the World Health Organization, alternative medicine includes reasoning, mastery, and practices from various cultures used in maintaining health and treating diseases [3]. Traditional healers are recognized in their communities and provide healthcare based on social, cultural, and sacred practices using natural elements [4]. Historically, alternative medicine served as the primary healthcare system for most Nigerians, representing the basis of medical care [5]. In modern Nigeria, alternative medicine coexists with conventional medicine, promoting various healthcare systems. Traditional healers such as herbalists and spiritualists are essential primary healthcare providers, especially in rural areas, and are increasingly integrated into the formal healthcare system, demonstrating the growing importance of traditional medicine within the broader healthcare system [5]. This integration emphasizes the significance of cultural practices and indigenous knowledge in shaping healthcare choices and service delivery in Nigeria.

A significant percentage of the population uses alternative medicine as a primary or supplemental healthcare choice [6]. Knowledge of its safety, effectiveness, and possible advantages is essential for service delivery and healthcare planning. The study of alternative medicine creates opportunities for cooperation and integration with traditional healthcare systems and contributes to the documentation and preservation of the rich cultural legacy connected to conventional healing methods. The study of alternative medicine creates opportunities for cooperation and integration with traditional healthcare systems and contributes to the documentation and preservation of the rich cultural legacy connected to conventional healing methods. This study examines cultural perceptions, practices, challenges, and integration strategies for developing alternative medicine into the Nigerian healthcare system.

Nigeria is the most populous country in Africa, with over 200 million people in 2021, and faces significant health challenges across urban and rural regions [7]. These challenges include high rates of HIV/AIDS, TB, malaria, and maternal and infant mortality, with increasing incidence of non-communicable diseases such as diabetes and cardiovascular disorders [7]. Nigeria’s healthcare system has seen improvements over time, although significant disparities in access and quality of care persist in rural areas [8].

The Nigeria Medical Association reported that the Medical and Dental Council of Nigeria registered over 80,000 doctors in 2021 [9]. However, less than half of these registered doctors were actively practicing in the country. This discrepancy emphasizes a significant challenge in Nigeria’s healthcare system with the doctor-to-population ratio estimated to be between 4,000 and 5,000 people per doctor [9]. This ratio falls far below the World Health Organization’s recommended ratio of one doctor per 600 people [10]. The low doctor-to-population ratio has implications for access to quality healthcare services across Nigeria. Rural and neglected areas bear the brunt of this imbalance, experiencing limited access to medical professionals and essential healthcare facilities. This situation contributes to disparities in health outcomes between urban and rural populations, increasing existing healthcare inequalities.

Traditional medicine practitioners in Nigeria operate under partial recognition and regulation by the Federal Ministry of Health’s Traditional Medicine Department [11]. Practitioners are certified and registered with relevant regulatory agencies to practice legally. However, enforcement methods and regulatory frameworks vary across states, thereby impacting licensing requirements based on specific traditional healing practices and state laws [11].

Alternative medicine in Nigeria reflects its rich traditions and diversified cultural heritage. Over 250 ethnic groups constitute the country’s multicultural civilization, each with its own traditional customs and beliefs about health and healing. These differences contribute to various aspects of attitudes towards and usage of alternative medicine across the country [12]. Nigerian cultural conceptions of health and well-being are firmly ingrained in customs and traditional beliefs. Traditional healers, sometimes known as herbalists or native doctors perform an essential part of the provision of alternative medical services [12]. These healers treat various illnesses using a broad range of natural treatments, including plants, roots, and animal products. The faith Nigerians have in these traditional healers, who are usually seen as community leaders with specialized expertise passed down through the centuries, is a clear indication of the acceptance of alternative medicine in Nigerian culture [13].

Religion also has a significant influence on the way the country’s culture views alternative medicine. Islam, Christianity, and native African religions are among the different religious traditions practised in the country.  While some religious communities view alternative medicine with scepticism, others integrate conventional medical procedures into their spiritual frameworks. For example, the use of medicines and rituals is combined with spiritual beliefs in many indigenous African faiths, resulting in a holistic approach to healing [14].

Nigeria is rich in cultural and traditional heritage, which shapes health beliefs and practices, leading to increased accessibility and cost-effectiveness of alternative medicine, especially in rural areas. Herbal medicine significantly contributes to alternative medicine, with traditional healers predominantly providing herbal therapies using plants such as neem, bitter kola, and moringa for their therapeutic benefits [3, 4]. This reliance on herbal medicine is widespread among Nigerians, demonstrating its popularity and efficacy in treating various diseases [4].

Another significant aspect of alternative medicine in Nigeria is spiritual healing, where traditional healers, including spiritualists and priests, use rituals and spiritual approaches, invoking spiritual forces through prayers, incantations, and rituals to treat medical conditions [4]. Traditional bone setting, a technique used to treat musculoskeletal injuries and fractures, is practiced by traditional bone setters, who usually lack formal medical training but employ methods passed down through generations, particularly benefiting rural areas [4].

The imperative to integrate complementary and alternative medicine with modern healthcare has recently generated attention leading to government regulations and initiatives to integrate traditional healers into the healthcare system for a more comprehensive patient treatment approach [15]. The National Policy on Traditional Medicine and Regulation of Herbal Medicine Practice in Nigeria exemplifies this effort, emphasizing collaboration between traditional healers and conventional healthcare providers to protect public health through strict regulation enforcement, ensuring quality, safety, and efficacy standards in traditional medicine practices. This collaborative approach improves healthcare access and delivery, especially in neglected communities,to promote mutual respect and understanding between different healthcare systems [15]. Such integration efforts promote a more comprehensive and inclusive healthcare system, addressing various healthcare needs, improving health outcomes, and reducing healthcare disparities across Nigeria. Research and development shape and influence the status of alternative medicine in Nigeria, emphasizing the importance of collaborative strategies and regulatory frameworks to enhance healthcare provision and outcomes.

Alternative medicine significantly contributes to Nigeria’s healthcare system by complementing conventional practices. However, numerous challenges impede its integration into mainstream healthcare. These challenges demonstrate the complexities surrounding alternative medicine in the country. One fundamental challenge is the absence of standards and regulations, unlike the stringent regulatory systems governing conventional medicine [16]. This lack of oversight raises concerns about the safety and effectiveness of alternative treatments, promoting skepticism among healthcare providers and the public.

The coexistence of various traditional treatment methods further complicates standardization and quality control efforts [5]. Variability in indigenous healing techniques across ethnic groups and regions makes it challenging to establish consistent guidelines for accreditation, practice, and training in alternative medicine. In addition, the limited scientific evidence supporting the effectiveness of many alternative medicines poses another significant challenge [17]. Some traditional therapies that have been passed down through generations usually lack empirical support from rigorous scientific studies, hindering their acceptance in the broader healthcare community.

Alternative medicine also faces stigma and marginalization within Nigeria’s healthcare system, with conventional practitioners usually viewing these therapies with skepticism [3]. This attitude limits collaboration and integration opportunities with mainstream healthcare services. Insufficient funding and resources further hinder the development and advancement of alternative medicine in Nigeria [16]. Government healthcare investments primarily prioritize conventional practices, leaving alternative practitioners with limited resources for research, education, and infrastructure.

Access to alternative medicine services, especially in rural areas, is also a concern because of cost barriers and coordination challenges with traditional treatments [5]. Low-income individuals may find alternative therapies unaffordable, thereby limiting their access. Moreover, concurrent use with conventional treatments can lead to risks and complications without proper regulation and coordination between traditional healers and medical professionals [17]. These challenges demonstrate the need for regulatory frameworks, increased funding, and improved coordination between traditional and modern healthcare systems to enhance the integration and accessibility of alternative medicine in Nigeria’s healthcare system.

Interest in alternative medicine has increased in recent years, driven by the need for accessible healthcare, cultural preservation, and holistic well-being. Several necessary steps should be taken to fully integrate alternative medicine into Nigeria’s healthcare system.  A primary challenge is the lack of standardized training for practitioners, which necessitates the development of official educational programs to enhance understanding and encourage an integrated approach to patient care.

Moreover, establishing strong scientific evidence to support the safety and effectiveness of alternative medicine is necessary for its widespread acceptance. Collaborative efforts among researchers, healthcare institutions, and traditional healers can lead to evidence-based practices and facilitate their integration into mainstream healthcare systems. The establishment of dedicated research centers can further validate successful therapies and promote their incorporation into standard healthcare practices.  A robust regulatory framework is essential to ensure the safety and quality of alternative medical practices in Nigeria. This includes establishing licensing, certification procedures, and clear regulations to promote growth while safeguarding against dishonest practices. Public knowledge and awareness of the benefits and risks of alternative medicines are also necessary to involve community outreach initiatives and public health campaigns.

Integrating alternative medicine into the traditional healthcare system can lead to more comprehensive and patient-centered care. Collaborative efforts between traditional healers and medical professionals, supported by government initiatives such as integrative healthcare facilities, can improve healthcare outcomes across the country. Respecting cultural diversity and customary healing methods is important in this integration process, emphasizing the need for cultural competence training among healthcare professionals. Nigeria and other countries can successfully integrate alternative medicine into its healthcare system by addressing these key areas and prioritizing equitable access and resource allocation. This approach can enhance patient outcomes, support inclusive healthcare practices, and bridge gaps in healthcare access for marginalize communities.

The inclusion of alternative medicine in Nigeria’s healthcare system reflects the country’s cultural diversity and the significance of its ancient healing traditions and is not only a practical requirement. This is necessary for a pluralistic healthcare system that values the benefits of both traditional and modern medicine. Through this integration, healthcare inequities can be reduced and communities can be empowered to provide a more inclusive approach to health and well-being. Stakeholders such as traditional healers, medical professionals, legislators, researchers, and the community should work together to realize this vision. It necessitates a shared commitment to advancing the health and well-being of Nigerians and an understanding of and respect for various healthcare approaches. Nigeria can fully utilize alternative medicine by promoting cooperation and understanding among its citizens, which would help create a more effective and culturally sensitive healthcare system.

Declarations

Not applicable

Consent for publication

Not applicable

Competing interests

None

There was no funding for this article.

All relevant data sources are cited in the article.

Conceptualization, data curation, methodology, resources, writing – original draft: DA, PKF, JBO, KEO, SNS, DELP

Supervision, Writing – review & editing: DA, DELP

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