TOPIC

HOUSEHOLD PREFERENCE TO TRADITIONAL MEDICINE AND THE FACORRS THAT

INFLUENCE HOUSEHOLD PREFERENCE TO TRADITIONAL MEDICINE: CROSS-
SECTIONAL STUDY

BY

NAME

Muhammed F Hydara

GC NUMBER

214234

A Dissertation Submitted in Partial Fulfilment of the Requirements for the Award of Higher National
Diploma in Public and Environmental Health

SUPERVISOR:

Mr Lamin Darboe

Gambia College, School of Public Health

Brikama, The Gambia

December, 2023
DECLARATION
This work has not been previously submitted for any other course or program at the Gambia College
School of public and environmental health.

A research study submitted in partial fulfillment of the requirements for the completion of the Highest
national diploma in school of public and environmental health.

This research is a sole product of my independent work, unless otherwise indicated. Other sources are
well acknowledge and referenced.

1
DEDICATION
This research is dedicated to my family for their supports and encouragement throughout must
especially my uncle. May Almighty Allah bless them all. I will also dedicate this work to all my
friends who have one way or the other contributed to the success of this work.

2
ACKNOWLEDGEMENT
This research was successfully due to the support and motivation of my supervisor Mr Lamin Darboe
and the ongoing support and encouragement of my family throughout. I deeply appreciate it. Finally, I
thank Allah for giving me the strength and the health to do this work.

3
ABSTRACT
Background; The term traditional medicine is used to describe traditional medical practices that have
been in existence even before the advent of modern medicine. Traditional medicine is an art of
treatment practices, strategies, knowledge, and beliefs including plant-, animal-, and mineral-based
medicines, spiritual therapies, manual techniques, and workouts applied singularly or in combination to
treat, identify, and prevent illnesses or uphold the well-being. Since ancient times, humans have been
using natural products, such as plants, animals, microorganisms, and oceanic organisms, in remedies to
prevent or treat ill-ness

Objectives; To determine household preference to traditional medicine

Results; The findings of this results shows that majority of the respondents 51.3% (n=137) were 40
year & above, 56.9% (n=152) were female, 55.1% (n=147) were married, 78.3% (n=209) have a
monthly income of 1001-10000 Dalasis, The religion of the respondents, 89.5% (n=89.5) were
Muslims, 28.1% (n=75) were non formal education and the occupation of majority of the respondents
are 17.2% (n=46) Housewife/husband and majority 98.5% (n=263) of the respondents were aware of
the use of traditional medicine and 64% of the respondents prefer traditional medicine.

Conclusion; In conclusion the research aimed at determining household preference to traditional

medicine and the factors that influence household preference to traditional medicine. The study
revealed that more than half 64% of the participants prefer to use traditional medicine. The findings of
this research revealed that there is strong association between households preference Affordability,
religious affiliation, distance from home, therapeutic effectiveness, cultural influence, and trust to
traditional medicine were reasons for preferring traditional medicine. Marital status, occupation,
religion, and educational level were determinants of the preference and practice of traditional medicine.

4
Table of Contents
DECLARATION.....................................................................................................................................ii

DEDICATION........................................................................................................................................iii

ACKNOWLEDGEMENT.....................................................................................................................iv

ABSTRACT.............................................................................................................................................v

LIST OF TABLES..................................................................................................................................ix

ABBREVIATION....................................................................................................................................x

CHAPTER ONE......................................................................................................................................1

1. INTRODUCTION............................................................................................................................1

1.1. Background...............................................................................................................................1

1.2. Statement of the Problem.........................................................................................................2

Overview................................................................................................................................................2

1.3. Significance................................................................................................................................3

1.4. Research Questions or Hypotheses.........................................................................................3

1.5. Objectives of the Study.............................................................................................................3

1.5.1. Main Objectives.................................................................................................................3

1.5.2. Specific Objectives.............................................................................................................3

1.6 Operational Definition of Terms......................................................................................................4

CHAPTER TWO.....................................................................................................................................5

5
2.0. LITERATURE REVIEW............................................................................................................5

2.1To determine household preference to traditional medicine.........................................................5

2.2To determine Factors that influence household preference for traditional medicine....................6

CHAPTER THREE.................................................................................................................................6

3.0 METHODOLOGY.......................................................................................................................6

3.1 Study Design..............................................................................................................................6

3.2 Study Area.................................................................................................................................6

3.3 Study Population.......................................................................................................................7

3.4 Sample Size Determination......................................................................................................7

3.5 Inclusion.....................................................................................................................................8

3.6 Exclusion Criteria.....................................................................................................................8

3.7 Sampling Procedures................................................................................................................8

3.8 Data Collection Methods..........................................................................................................8

3.9 Data Collection Instruments....................................................................................................8

3.10 Reliability and Validity of Instruments..................................................................................8

3.11 Data Collection Procedures......................................................................................................9

3.12 Study Variables.........................................................................................................................9

3.12.1 Independent Variables......................................................................................................9

3.12.2 Dependent Variable(s).......................................................................................................9

3.13 Data Management.....................................................................................................................9

3.14 Data Analysis.............................................................................................................................9

3.15 Ethical Procedures....................................................................................................................9

CHAPTER FOUR.................................................................................................................................10

4.0 RESULTS AND DISCUSSION.................................................................................................10

Table 4.1 shows socio demographic information of the respondents..................................................10

6
 Table 4.2 shows Chi square test against preference of traditional medicine and socio demographic
characteristic........................................................................................................................................12

Table 4.3 shows Bivariate regression analysis of household preference to traditional medicine and
socio demographic information...........................................................................................................14

Table 4.4 shows Descriptive analysis of Household preference to traditional medicine....................17

Figure 4.1 shows charts of household preference of traditional medicine..........................................19

Table 4.5 shows factors influencing household preference to traditional medicine............................20

Table 4.6 showing Chi square test for household preference to traditional medicine against factors
influencing household Preference to traditional medicine...................................................................21

Table 4.7 Bivariate regression analysis of household preference to traditional medicine and factors
that influence household preference to traditional medicine...............................................................22

DISCUSSION.........................................................................................................................................23

CHAPTER FIVE...................................................................................................................................26

5 CONCLUSION AND RECOMMENDATION...........................................................................26

5.7 CONCLUSION.......................................................................................................................26

5.8 RECOMMENDATION..........................................................................................................26

5.9 STRNGTH AND LIMITATION OF THE STUDY................................................................26

5.9.1 Strength............................................................................................................................26

5.9.2 Limitation.........................................................................................................................26

REFERENCES......................................................................................................................................27

7
8
LIST OF TABLES
Table 4.1: socio demographic information of the respondents

Table 4.2: shows Chi square test against preference of traditional medicine and socio
demographic characteristic

Table 4.3 shows Bivariate regression analysis of household preference to traditional medicine
and socio demographic information

Table 4.4 shows Descriptive analysis of Household preference to traditional medicine

Table 4.5 shows factors influencing household preference to traditional medicine

Table 4.6 showing Chi square test for household preference to traditional medicine against
factors influencing household Preference to traditional medicine

Table 4.7 Bivariate regression analysis of household preference to traditional medicine and
factors that influence household preference to traditional medicine

9
ABBREVIATION
TM= Traditional medicine

WHO= World health organization

10
CHAPTER ONE
1. INTRODUCTION
1.1. Background
The term traditional medicine is used to describe traditional medical practices that have been in
existence even before the advent of modern medicine. Traditional medicine is an art of treatment
practices, strategies, knowledge, and beliefs including plant-, animal-, and mineral-based medicines,
spiritual therapies, manual techniques, and workouts applied singularly or in combination to treat,
identify, and prevent illnesses or uphold the well-being. Since ancient times, humans have been using
natural products, such as plants, animals, microorganisms, and oceanic organisms, in remedies to
prevent or treat ill-ness (Chali et al., 2021)In Africa, traditional medicine is part of the first set of
response mechanisms for medical emergencies, whereas in others, the whole health system of the
community relies on medicines embedded in indigenous practice and belief(Agbor & Naidoo, 2016).

Sub-Saharan Africa is one of the regions of the world in which traditional medicine has long been held
to be wide spread with considerable number of the population relying on it to maintain their health.
Traditional medicine is part of the first set of response mechanisms for medical emergencies, whereas
in others, the whole health system of the community relies on medicines embedded in indigenous
practice and belief. This is due to the fact that modern pharmaceuticals and medical procedures remain
unreachable to a large number of the population due to their relatively high cost and concentration of
health facilities in urban centers. Also, due to its intrinsic qualities, unique and holistic approaches as
well as accessibility and affordability made it the best alternative care preferred by most of the
population especially in the rural communities of most developing countries.(James et al., 2018)

However, despite the high consideration given to the traditional medicine practice around the world, it
seems to face numerous challenges. The most important recognized challenge is the lack of a reference
standard for determining the proper dosage of the traditional medicine for the patients. This in turn has
resulted in the creation of incorrect and incomplete information about the traditional medicine drugs.
Another very important challenge is the lack of national policy to manage and legalize the practice of
using traditional medicine. However, various studies in other African countries have come up with the
following findings, In Uganda, Preference of the Community for the Management of Different
Ailments for the Future, the majority (75.3%)) of them preferred modern medicine, and only (9.2%) of

11
the participants preferred the use of traditional medicine for any types of ailments (Abbo et al., 2019).
According to (Chali et al., 2021), he conducted a study in Ethiopia on determinants of traditional
medicine practice and revealed that the affordability of traditional medicine contributed to its use by up
to 80% of the population, whilst 20% added deprived access to modern healthcare facilities as the
reason for its used.

1.2. Statement of the Problem

Overview
Globally, an estimated 25% of pharmaceutical preparations and more than 50% in the USA contain
plant derived active principle(Addis et al., 2015). The WHO has estimated that about 65 – 80% of the
world population uses traditional medicine.

According to (Chali et al., 2021), The World Health Organization (WHO) estimated that , majority of
the population in developing countries depend on traditional and herbal medicines as their primary
source for health care and The Gambia is definitely no exception. Therefore, it is appropriate to assess
the preference and practice of traditional medicine and its determinants and reasons for preferring the
practices and possible factors triggering the continuous interest in traditional medicine among the
community.

According to a study by (Street et al., 2016) have stated that, an estimated 72% of the Black African
population in South Africa relying on traditional medicine, accounting for some 26.6 million
consumers. Another study conducted in Ethiopia by (Addis et al., 2015) has revealed that about 79% of
the respondents have at least once visited a traditional healer to seek for treatment and 71.4% believe
that traditional medicine is important for maintaining health

In Ghana a study by (Gyasi et al., 2019) has revealed that (78.3%) of the participants visits a
traditional healers first for their present complaint. For personal medical remedy, (34.8%) of the
participants had visited traditional healers at least once in their lifetime. The result recorded for
personal preference for modern healthcare service showed that (78.3%) prefer the modern medical
system over the traditional and only (21.7%) chose traditional medicine. The Gambia is no exception,
however there are no published literatures regarding the topic in discussion as a result; it’s difficult to
quantify the magnitude of the problem nationally.

12
1.3. Significance
The study is aimed to determine household preference to traditional medicine and factors that
influence household preference to traditional medicine. A study conducted in Saudi Arabia show
that 94.9% of the information regarding Traditional medicine came from informal source (friends,
family) (Jifar, 2022) and the same study shows that 20.8% of Traditional medicine users had
encounter one or more side effect . Another study conducted by (Habtom, 2018) shows that 95%
of traditional medicine practice do not maintain records of their patients. The findings of the study
provide information on household preference and also the factors for the preference of traditional
medicine. Recommendations made in this study are going to help the authorities and policy makers
in their quest to adequately address the needs of the community.

In addition, the findings of this study can also serve as a baseline data in advocating for large scale
researches on this topic. This will further trigger interventions such as setting up committees to
regulate the practice of traditional medicine as they do for modern medicine. Since as of this
moment, there are no published literatures nationally.

1.4. Research Questions or Hypotheses

Do household members prefer traditional medicine?

Why do household members prefer traditional medicine?

1.5. Objectives of the Study

1.5.1. Main Objectives
To determine household preference to traditional medicine
1.5.2. Specific Objectives
To Identify Factors that influence household preference to traditional medicine

13
 1.6 Operational Definition of Terms
Households = household consists of one or more persons who live in the same dwelling

Traditional medicine: traditional medicine refers to health practices, approaches, knowledge and
beliefs incorporating plant, animal and minerals based medicines, spiritual therapies, manual
techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses
or maintain well-being

14
CHAPTER TWO
2.0. LITERATURE REVIEW

2.1To determine household preference to traditional medicine

The use of traditional medicine is increasing worldwide, a survey conducted by WHO (2018) has
estimated that about 65- 80% of the world’s people uses herbal medicine for treating their
sicknesses. Similarly, a study conducted by (Adorisio et al., 2016) has also put forward that the use
of traditional medicine in the developed countries is steadily gaining momentum. In the United
States, 38.3% of adults and 11.8% of children have used some form of CAM, and many physicians
in Europe and North America have referred their patients for acupuncture (43%), chiropractice
(40%), and/or massage therapy (21%). Furthermore, In Africa, up to 80% of the population uses
traditional medicine for primary health care (WHO, 2003)(Addis et al., 2015).

According to Abbo et al (2019), in Uganda, nearly 80% of the population relies on traditional
medicine for their mental health care. According to a study by (Street et al., 2016) have stated that,
an estimated 72% of the Black African population in South Africa relying on traditional medicine,
accounting for some 26.6 million consumers. Another study conducted in Ethiopia by (Addis et al.,
2015) has revealed that about 79% of the respondents have at least once visited a traditional healer
to seek for treatment and 71.4% believe that traditional medicine is important for maintaining
health. The same study further stated that 98% of the respondents prefer traditional medicine due to
cultural reasons whereas 65% of them indicated efficacy of the preparation as the main reason
behind its acceptance. (Chali et al., 2021) has revealed that majority of the respondents (75.3%)
preferred modern medicine, and only (9.2%) preferred the use of traditional medicine for any types
of ailments. The study further stated that the reasons for the preference of traditional medicine, all
the respondents (100.0%) says affordability and about (84.0%) stated religious affiliation as the
reason for their preference. Chali et al., (2021) conducted a study in Ethiopia on determinants of
traditional medicine practice and revealed that the affordability of traditional medicine contributed
to its use by up to 80% of the population, while 20% added deprived access to modern healthcare
facilities as the reason for its used. However a study conducted in Ghana by Gyasi et al., (2011) has
15
 revealed that (78.3%) of the participants visits a traditional healers first for their present complaint.
For personal medical remedy, (34.8%) of the participants had visited traditional healers at least
once in their lifetime. the result recorded for personal preference for modern healthcare service
showed that (78.3%) prefer the modern medical system over the traditional and only (21.7%) chose
traditional medicine.

2.2To determine Factors that influence household preference for traditional medicine

A study conducted in Ethiopia stated that 98% of the respondents prefer traditional medicine
due to cultural reasons whereas 65% of them indicated efficacy of the preparation as the main
reason behind its acceptance(Addis et al., 2016). Also a study conducted by (Nigussie et al.,
2022) on the practice of traditional medicine and associated factors among resident in eastern
Ethiopia reveal that educational level, occupation, and history of chronic diseases were
significantly associated with traditional medicine practice. Participants with a diploma degree
or higher were more than three times more likely to use traditional medicines than those who
were unable to read and write. In this study, Farmers were 1.06 times more likely to use
traditional medicines than participants who were government employees. Participants with no
history of chronic illness were 79% less likely to use traditional medicine than.

Another research conducted by (Chali et al., 2021) revealed in the result that more than
Accessibility of Traditional Medicine(TM) was significantly associated with parental
Traditional Medicine(TM) use for their children. Among the total respondents, (59.3%)
perceived Traditional Medicine (TM) as it is being easily accessible. Those parents who
perceived Traditional Medicine (TM) as it is being easily accessible were 2.94 times more
likely to use Traditional Medicine (TM) for their children.

16
 CHAPTER THREE
3.0 METHODOLOGY
3.1 Study Design
Cross-sectional study design was used.
3.2 Study Area
Brikama is the largest town within the Kombo Central, is located in West Coast Region
with a population of 699,704 people in which 351,482 are males and 348,222 are
females with a growth rate of 6.1( GBoS,2013). Brikama is 32km away from the capital
Banjul, and it comprises all ethnic groups in the Gambia which include: Mandinka,
Wollofs, Jola, Sarahule, Serere, Manjago, and Fulas. Brikama is divided into twenty-
four (24) wards,and Gidda is a ward in Brikama and the second largest ward within
Brikama.
3.3 Study Population
The study population is 699,704 (GBos,2013). A sample size of 267 respondents was
selected for this study using epi info. A sample has been selected in order to save time
and also since this research is self-funded, selecting just a sample from the larger group
will enable the researcher to manage the little resources in hand and still have data that
could be a representation of the group the sample has been chosen from. The study
population will include both male and female in households and the age category will be
from 18 years and above including all tribe found in the community.
3.4 Sample Size Determination
Epi info was used in calculating sample size base on the population size of 699,704 with a
confidence level of 95% and this generated a total sample size of 267.

17
 3.5 Inclusion
In this study, the inclusion criteria was all males and females that are above 18 years who are
available at the time of the study and were willing to provide consent was included

3.6 Exclusion Criteria

The participants who were below 18 years were excluded and those who are severely sick
3.7 Sampling Procedures
Convenient sampling was used to select the study area and to select the required respondents
from the targeted population to participate in this study. This technique is chosen for easy
access by the researcher. This means that all respondents who are present at the time of data
collection and are willing to participate will be conveniently selected to participate by the
researcher.

3.8 Data Collection Methods

Data was collected was through the use of questionnaires that were transported to kobotool
consisting of questions on age, gender, years of experience, and questions under household
18
 preference to traditional medicine and the factors that influence household preference to traditional
medicine which will be given to each participant to fill.

3.9 Data Collection Instruments

The data collection tool for this research was self-administered questionnaires through the use of
kobotool website.

3.10 Reliability and Validity of Instruments

The instrument was self-administering questionnaire that was pre-test to nearby
households to see if the instrument will consistent and accurate before data will
be collected
3.11 Data Collection Procedures

3.12 Study Variables

3.12.1 Independent Variables
The sociodemographic factors such as age, sex, marital status, ethnicity, educational level, and monthly
income
3.12.2 Dependent Variable(s)
The dependent variables of the study are the household preference to traditional medicine and the
factors that influence household preference to traditional medicine.
3.13 Data Management
Responds questionnaires was entered in statistical package for social science software
(SPSS V20) and the data was cleaned by frequency of all variables to check for
incorrect coding
3.14 Data Analysis

Data were sorted and analyzed using statistical package for social science (SPSS)
version 20 Descriptive statistics were used for organizing, describing, and summarizing
the data. Chi-square (X2) was used to check the association of independent variables
with the dependent variable and association of independent variable with the factors. P

19
 value <0.05 was used to declare the significant association. Further bivariate logistic
regression analysis was done among variable that shows significant value of ≤ 0.05 to
show prediction among variables
3.15 Ethical Procedures
Permission was sought from the respondents. They were informed that participation is voluntary and
that they can withdraw from the study at any given time they deem necessary. Participants will be
assured of highest degree of confidentiality

20
 CHAPTER FOUR

4.0 RESULTS AND DISCUSSION

Table 4.1 shows socio demographic information of the respondents

3 Variables Frequency Percent (%)

Age group
< 20 Years 7 2.7
20 - 29 Years 61 22.8
30 - 39Years 62 23.2
40 Years & above 137 51.3

Income
Variables Frequency Percent (%)
<1000 42 15.7
Others 27 10.2
1001-10000 209 78.3
private_business_owne 42 15.7
>10000 16 6.0
r
Ethnicity Student 39 14.6
Fula 67 25.0
Education
Jola 37 13.9
no_formal_education 75 28.1
Mandinka 88 33.0
Others 50 18.7
Wolof 45 16.9
Primary 21 7.9
Others 30 11.2
Secondary 43 16.1
Religion Tertiary 60 22.5
Christianity 27 10.1 vocational training 18 6.7
Muslim 239 89.5
Sex
Others 1 0.4

Occupation Female 152 56.9

daily worker 43 16.1 Male 115 43.1
Farmer 28 10.5
Marital status
government worker 42 15.7
Divorced 15 5.6
Housewife/husband 46 17.2
Married 147 55.1
Single 57 21.3
21
Widowed 48 18.0
Table 4.1 shows the sociodemographic information of the respondents in Brikama Town. The age of
the respondents corresponds to 51.3% (n=137) 40 year & above, 56.9% (n=152) were female and male
were 43.1% (n=115). The marital status of the respondents were, married 55.1% (n=147), single 21.3%
(n=57), widowed 18.0% (n=48) and divorced 5.6% (n=15). The ethnicity of the respondents were:
Mandinka 33% (n=88) , Fula 25% (n=67), Wolof 16.9% (n=45), Jola 13.9% (n=37) and Others 11.2%
(n=30). The respondent’s income levels were: 1001-10000 78.3% (n=209), <1000 15.7% (n=42),
≥10000 6.0% (n=16).The religion of the respondents, 89.5% (n=89.5) were Muslims, 10.1% (n=27)
were Christians and 0.1% (n=0.4%) were others. The Educational level of the respondents corresponds
to 28.1% (n=75) were non formal education, 22.5% (n=60) were tertiary, 18.7% (n=50) were others,
16.1% (n=43) were secondary, 7.9% (n=21) were primary and 6.7% (n=18) were vocational training.
Respondent’s Occupations were; 17.2% (n=46) Housewife/husband, 15.7% (n=42) government
worker, 15.7% (n= 42) private-business owner, 16.1% (n=43) daily worker, 14.6% (n=39) students,
10.5% (n=28) farmers and 10.2% (n=27) others.

22
Table 4.2 shows Chi square test against preference of traditional medicine
and socio demographic characteristic
Preference of traditional
medicine
Yes No P value
Religion Christianity 21(77.8%) 6(22.2%0
Muslim 149(62.3% 90(37.7%
0.163
) )
Others 1(100%) 0(0.00%)
age group < 20 Years 1(14.3%) 6(85.7%)
20 - 29 Years 17(27.9%) 44(72.1% 0.000
)
30 - 39Years 36(58.1%) 26(41.9%
)
40 Years & above 117(85.4% 20(14.6%
) )
Ethnicity Fula 32(47.8%) 35(52.2%
)
Jola 30(81.1%) 7(18.9%)
Mandinka 52(59.1%) 36(40.9%
0.001
)
Others 22(73.3%) 8(26.7%)
Wolof 35(77.8%) 10(22.2%
)
occupatio Daily worker 31(72.1%) 12(27.9% 0.000
n )
Farmer 27(96.4%) 1(3.6%)
Government worker 10(23.8%) 32(76.2%
)

23
 housewife__husband 41(89.1%) 5(10.9%)
Others 22(81.5%) 5(18.5%)
private_business_own 32(76.2%) 10(23.8%
er )
Student 8(20.5%) 31
(79.5%)
Education no_formal_education 68(90.7%) 7(9.3%)
Others 46(92.0%) 4(8.0%)
Primary 12(57.1%) 9(42.9%)
Secondary 16(37.2%) 27(62.8%
0.000
)
Tertiary 15(25.0%) 45(75.0%
)
Vocational training 14(77.8%) 4(22.2%)
Sex Female 70(58.3%) 50(41.7%
)
0.052
Male 101(68.7% 46(31.3%
) )
Marital Divorced 8(53.3%) 7(46.7%)
status Married 103(70.1% 44(29.9%
) )
0.000
Single 13(22.8%) 44(77.2%
)
Widowed 47(97.9%) 1(2.1%)
Income <1000 23(54.8%) 19(45.2%
level )
1001_10000 142 67(32.1%
0.021
(67.9%) )
>10000 6(37.5%) 10(62.5%
)

24
Table 4.2 shows the results of chis square test of household preference to traditional medicine against
the socio demographic information; there is significant association between household preferences to
traditional medicine and the socio demographic information, Age (p value=0.000), ethnicity (p
value=0.001), Educational level (p value=0.000), occupation (p value=0.000), marital status (p
value=0.000) , income level (p value=0.021). The table depicts that there is no significant association
between household preference to traditional medicine and socio demographic information of; Religion
(p value=0.163) and Sex (p value=0.052)

Table 4.3 shows Bivariate regression analysis of household preference to

traditional medicine and socio demographic information
95% C.I.for
AOR
Lowe Uppe
B Wald Sig. AOR r r
Step 1a age group 3.785 .286
HOUSEHOLD
<20 REF REF
PREFERENCE
20-29years -.310 .056 .812 .734 .057 9.477
TO
30-39years -.717 .230 .632 .488 .026 9.149
TRADITIONAL
≥40 years - 1.031 .310 .215 .011 4.186
MEDICINE
1.539
AGAINST SOCI
Ethnicity 6.970 .137
DEMOGRAPHIC
Fula REF REF
Jola - 6.388 .011 .142 .031 .645
1.955
Mandinka -.928 3.060 .080 .395 .140 1.118
Others - 2.506 .113 .290 .063 1.342
1.237

25
Wolof -.277 .195 .659 .758 .222 2.592
Occupation 13.58 .035
9
Daily worker REF REF
Farmer - 1.367 .242 .246 .023 2.581
1.401
Government 2.187 6.354 .012 8.911 1.627 48.81
worker 1
Housewife/ - 1.756 .185 .346 .072 1.662
Husband 1.060
Others .468 .317 .574 1.597 .313 8.143
Private business -.477 .453 .501 .620 .155 2.491
owner
Student .516 .255 .614 1.675 .226 12.39
8
Education 5.530 .355
No, formal REF REF
education
Others -.226 .083 .773 .798 .172 3.706
Primary 1.284 3.118 .077 3.610 .868 15.00
6
Secondary .965 1.809 .179 2.625 .643 10.71
5
Tertiary .596 .411 .522 1.814 .293 11.22
2
Vocational .725 .565 .452 2.064 .312 13.65
training 5
Female REF REF
Male .416 .854 .355 1.515 .628 3.659
marital status 7.282 .063

26
 Divorced
Married - 3.216 .073 .248 .054 1.138
1.393
Single -.549 .261 .609 .577 .070 4.739
Widowed - 6.040 .014 .036 .003 .511
3.312

95% C.I.for
AOR
B Wald Sig. AOR Lower Upper
income .927 .629
level
<1000 REF REF
1001- -.182 .065 .799 .833 .205 3.385
10000
>10000 .550 .302 .582 1.732 .244 12.289
Constant 1.514 .672 .412 4.543

Table 4.3 revealed that respondents who are <20 years are 26.6% less likely to prefer traditional
medicine than those in age category of 20-29 years (AOR: 0.734, 95% CI: (0.057, 9.477), respondents
who are <20 years are 51.2% less likely to prefer traditional medicine than those in 30-39 years and
respondents in age category <20 years are 87.5 less likely to prefer traditional medicine than those in
40 ≥ years. The respondents that are Fulas are 85.5% less likely to prefer traditional medicine than Jola
(AOR: 0.142, 95% CI: (0.057, 9.477), Respondents that are Fulas are 60.5% less likely to prefer
traditional medicine than Mandinkas. Respondents that are Fulas 71% less likely to prefer traditional
medicine than those that belongs to others, and respondents that Fulas are 24.2% less likely to prefer
traditional medicine than Wolofs. Respondents whose occupation is daily worker are 75.4% less likely
to prefer traditional medicine than respondents whose occupation are Farmer (AOR: 0.246, 95% CI:

27
0.023, 2.581), Respondents whose occupation is daily worker are 8.911 times more likely to prefer
traditional medicine than respondents who are government worker (AOR: 8.911, 95% CI: 1.627,
48.11) , Respondents whose occupation is daily worker are 65.4% less likely to prefer traditional
medicine than respondents who are Housewife/ Husband (AOR:, Respondents whose occupation is
daily worker are 1.597 times more likely to prefer traditional medicine than Respondents whose
occupations belongs to others (AOR: 1.597, 95% CI: (0.313, 8.143) , Respondents whose occupation is
daily worker are 38% less likely to prefer traditional medicine than respondents who are private
business owner (AOR: 0.620, 95% CI: (0.155, 2.491) and Respondents whose occupation is daily
worker are 1.675 more likely to prefer traditional medicine than respondents who are students (AOR:
1.675, 95% CI: (0.226, 12.398). Respondents who have no formal education are 20.2% less likely to
prefer traditional medicine than those who educational level is others (AOR: 0.798, 95% CI: 0.172,
3.706), Respondents who have no formal education are 3.610 times more likely to prefer traditional
medicine than respondents whose educational level is primary (AOR: 3.610, 95% CI: (0.868, 15.006),
Respondents who have no formal education are 2.625 times more likely to prefer traditional medicine
than respondents whose educational level is Secondary (AOR: 2.625, 95% CI: (0.643, 10.715),
Respondents who have no formal education are 1.814 times more likely to prefer traditional medicine
than respondents whose educational level is Tertiary (AOR: 1.814, 95% CI: (0.293, 11.222), and
Respondents who have no formal education are 2.064 more likely to prefer traditional medicine than
respondents who attained vocational training (AOR: 2.064, 95% CI: (0.312, 13.655). Respondents who
are females are 1.515 more likely to prefer traditional medicine than respondents who are males (AOR:
1.515, 95% CI: (0.628, 3.659). Respondents who are divorce are 75.2% less likely to prefer traditional
medicine than respondents who are married (AOR: 0.248, 95% CI: (0.054, 1.138), Respondents who
are divorce are 42.3% less likely to prefer traditional medicine than respondents who are single (AOR:
0.577, 95% CI: (0.070, 4.739), and Respondents who are divorce are less 96.4% less likely to prefer
traditional medicine than respondents who are widowed (AOR: 0.036, 95% CI: (0.003, 0.511).
Respondents whose monthly income is <1000 Dalasis are 16.7% less likely to prefer traditional
medicine than respondents whose monthly income is between 1001-10000 Dalasis and respondents
whose monthly income is <1000 Dalasis are 1.732 times more likely to prefer traditional medicine than
respondents whose monthly income is >10000 Dalasis.

28
Table 4.4 shows Descriptive analysis of Household preference to traditional medicine
Household preference to traditional medicine

Frequency Percent(%)

Are you aware of the use of No 4 1.5

traditional medicine?
Yes 263 98.5

Where do you first visit Hospital 119 44.6

when you are sick?

Others 25 9.4

Traditional healer 123 46.1

Do you prefer traditional Yes 171 64

medicine?
No 96 36

What type of traditional holy water 14 5.2

medicine have you been
Bonesetter 27 10.1
using?
Herbs 118 44.2

herbs, holy water and spiritual 38 14.2

healer

herbs and holy water 70 26.2

What is your source of Family 92 34.5

information of traditional
Friend 109 40.8
medicine?
Health workers 12 4.5

Others 54 20.2

What ailments do you use Borne fracture 18 6.7

29
traditional medicine for?

Borne fracture, others 3 1.1

Headache 23 8.6

headache borne fracture 2 0.7

Headache, borne fracture & others 8 3

headache others 35 13.1

headache stomach ache 8 3

Headache, stomach ache & borne 9 3.4

fracture

Headache, stomach ache, borne 8 3

fracture & others

Headache, stomach ache & others 16 6

Others 69 25.8

Stomach ache 14 5.2

Stomach ache, borne fracture 6 2.2

Stomach ache, borne fracture & 16 6

others

Stomach ache others 32 12

30
Figure 4.1 shows charts of household preference of traditional medicine

Table 4.4 shows household preference to traditional medicine. The results shows that 98.5% (n=263)
of the respondents were aware of the use of traditional medicine and 1.5% (n= 4) of the respondents
are not aware of the use of traditional medicine. 64% (n=171) of the respondents prefer traditional
medicine and 36% (n=96) of the respondents do not prefer the use of traditional medicine. 46.1%
(n=123) of the respondents first visit traditional healer when they are sick, 44.6%.

Table 4.5 shows factors influencing household preference to traditional medicine

Frequency Percent
Effectiveness No 102 38.2
Yes 165 61.8

31
Affordability
No, I don’t believe 97 36.3
Yes, I believe 170 63.7
Accessibility
No, it is not 104 39.0
Yes, it is 163 61.0
Culture No, it hasn’t 130 48.7
Yes, it has 137 51.3
Trust No 89 33.3
Yes 178 66.7
Distance No 156 58.4
Yes 111 41.6

Table 4.5 shows the factors that influence household preference to Traditional medicine; Respondents
who responds to “effectiveness of traditional medicine” corresponds to 61.8% (n=165) were YES and
38.2% (n=102) were No. Respondents who responds to “Cost effectiveness of traditional medicine”
corresponds to 63.7% (n=170) were YES and 36.3% (n=97) were NO. Respondents who responds to
“Accessibility to traditional medicine” corresponds to 61.0% (n=163) were YES and 39.0% (n=104)
were NO. Respondents who responds to “Cultural influence” corresponds to 51.3% (n=137) were YES
and 48.7% were NO. Respondents who responds to “Trust to traditional medicine” corresponds to
66.7% (n=178) were YES and 33.3% (n= 89) were NO. Respondents who responds to “Distance from
health care service” corresponds to 58.4% (n=156) were NO and 41.6% (n=111) were YES.

Table 4.6 showing Chi square test for household preference to traditional medicine against
factors influencing household Preference to traditional medicine
preference of traditional
medicine P value
yes No
Effectiveness No 22 (21.6%) 80 0

32
 (78.4%)
Yes 149 16 (9.7%)
(90.3%)
cost No, I don’t 17 (17.5%) 80
effectiveness believe (82.5%)
0
Yes, I believe 154 16 (9.4%)
(90.6%)
Accessibility No, it is not 24 (23.1%) 80
(76.9%)
0
Yes, it is 147 16 (9.8%)
(90.2%)
Culture No, it hasn’t 43 (33.1%) 87
(66.9%)
0
Yes, it has 128 9 (6.6%)
(93.4%)
Trust No 8 (9.0%) 81
(91.0%)
0
Yes 163 15 (8.4%)
(91.6%)
Distance No 69 (44.2%) 87
(55.8%)
0
Yes 102 9 (8.1%)
(91.9%)

Table 4.6 shows chi square test for household preference to traditional medicine against factors that
influence household preference to traditional medicine; there is significant association between
household preference to traditional medicine and the following factors that influence household
preference to traditional medicine; effectiveness of traditional medicine (p value=0.000), Cost
effectiveness of traditional medicine (p value=0.000), easy accessibility to traditional medicine ( p

33
value=0.000), cultural influence ( p value =0.000), trust of traditional medicine ( p value=0.000) and
distance from healthcare facility ( p value= 0.000)

Table 4.7 Bivariate regression analysis of household preference to traditional medicine and
factors that influence household preference to traditional medicine
Factors influencing 95% C.I.for
household preference AOR
to traditional medicine B Wald Sig. AOR Lower Upper
Step Effectiveness -.526 .602 .438 .591 .156 2.232
1a No
Yes

Affordability -.893 1.781 .182 .409 .110 1.520

No
Yes
Accessibility -.347 .295 .587 .707 .203 2.469
No
Yes
Culture No -1.803 9.820 .002 .165 .053 .509
Yes
Trust No -3.211 29.489 .000 .040 .013 .128
Yes
Distance No .054 .009 .926 1.056 .334 3.341
Yes
Constant 3.051 45.156 .000 21.134

Table 4.7 revealed that respondents who said traditional medicine is effective are 40.9% more likely to
prefer traditional medicine than Respondents who said No traditional medicine effectiveness (AOR:
0.591, 95% CI: (0.156, 2.232). Respondents who said Yes traditional medicine are affordable are
59.1% more likely to prefer traditional medicine than respondents who said No to traditional medicine
affordability (AOR: 0.409, 95% CI: (0.110, 1.520). Respondents who said yes to easy accessibility to

34
traditional medicine are 29.3% more likely to prefer traditional medicine than respondents who said no
to easy accessibility to traditional medicine (AOR: 0.707, 95% CI: (0.203, 2.469). Respondents who
yes to cultural influence to traditional medicine are 83.5% more likely to prefer traditional medicine
than Respondents who said No (AOR: 0.165, 95% CI: (0.053, 0.509). Respondents who said Yes to
trust to traditional medicine are 96% more likely to prefer traditional medicine than respondents who
said no (AOR: 0.040, 95% CI: (0.013, 0.128). Respondents who said Yes to far distance from health
facility are 1.056 more likely to prefer traditional medicine than Respondents who said no (AOR:
1.056, 95% CI: (0.334, 3.341).

4.8 DISCUSSION

The study was aimed to determine household preference to traditional medicine and the factors that
influenced household preference to traditional medicine among household members in Brikama.
The findings of this study regarding the socio demographic factors show that majority of the
participants (51.3%) within the age of 40years and above. Most of the participants (78.3%) were
earning D1001-D10000 monthly. Majority of the participants (33.0%) were Mandinkas, followed
by (25.0%) for Fulas, (16.9%) for Wolof, (13.9%) for Jolas and (11.2%) for others. Most of the
participants in this study (89.5%) were Muslims by religion. Majority of the participants (17.2%)
were housewives/husband and the educational background of the participants was most of them
(28.1%) had no formal education. The findings of this study depicts that (56.9%) of the participants
were females by sex and (43.1%) were males. Majority of the participants (55.1%) were married,
followed by (21.3%) for single, (18.0%) were widowed, and (5.6%) for divorced.

35
A questionnaire was used to determine household preference to traditional medicine among 267
participants at Brikama Town. The findings of this study depict that majority (98.5%) of the
participants were aware of the use of traditional medicine. Most of the participants (46.1%) visit a
traditional healer first when they become sick and (64.0%) of the total participants at Brikama town
prefer the use of traditional medicine. Majority of the participants (44.2%) prefer the use of Herbs,
followed by (26.2%) prefer the use of herbs and holy water, (14.2%) prefer the use of herbs, holy
water and spiritual healer. (10.1%) prefer the use of borne setter and (5.2%) prefer the use of holy
water. The source of information form the participants depicts that majority (40.8%) heard their
information from Friends, 34.4% of them heard the use of traditional medicine from Family
members, (20.2%) heard from others, and (4.5%) heard their information from health workers.

A questionnaire was used to identify factors that influence household preference to traditional
medicine. The findings of this study revealed that majority (61.8%) of the participants prefer
traditional medicine because of its effectiveness. Most of the participants (63.7%) prefer traditional
medicine because of its Affordability. Majority (61.0%) of the participants prefer the use of
tradition medicine because of its easy accessibility. Most of the participants (51.3%) prefer the use
of traditional medicine because of cultural influence. Majority (66.7%) of the respondents prefer
the use of traditional medicine because they trust it. Majority (58.4%) of the participants did not
prefer the use of traditional medicine because of distance from healthcare service while (41.6%) of
the participants prefer the use of traditional medicine because of their distance from healthcare
service. The finding of this study revealed that factors like older ages, educational level, and middle
income level and married are associated with the use of traditional medicine this is similar study
conducted in Uganda whose findings revealed that Socioeconomic factors like older age, higher
educational level of education, high monthly income and being married were associated with
higher use of TM (Logiel et al., 2021). In this study, the preference to traditional medicine was
64.0% which is similar to the findings of a study conducted in Hossana Town southern Ethiopia
whose findings revealed that 73.1 % used herbal medicine during current pregnancy (Laelago et al.,
2016), and also similar to the study conducted in Nigeria whose findings revealed that 77.5% of
the participants used one form of traditional medication or the other when sick (Duru et al., 2016).
The finding of this study is different from a study conducted in southwest Ethiopia, which stated
that Only 9.2% of the participants preferred to use traditional medicine (Chali et al., 2021) and the
study is also high than the study conducted in Ethiopia which reported that 31.85% and 28.8% of

36
the participants preferred to use traditional medicine (Gari et al., 2018). The discrepancy might be
due to different sample size and the geographical area of the study. The findings of this study
revealed that 34.4% of the participants heard the use of traditional medicine from Family members.
The figure is different from the study conducted in southwest Ethiopia which stated that (54.3%) of
the respondents obtained information on the use, benefit, and efficacy of traditional medicine from
their family members (Chali et al., 2021)

The findings of this study revealed that 28.1% had no formal education which is higher than a
study conducted in India whose finding revealed that 19% Percent of those with no formal
schooling use traditional medicine as first preference (Ao & Lhungdim, 2020). This difference
might be because of people in India have access to formal education earlier than people in the
Gambia. Respondents who said Yes to traditional medicine are affordable are 59.1% more likely to
prefer traditional medicine than respondents who said No to traditional medicine affordability
(AOR: 0.409, 95% CI: (0.110, 1.520) this is slight lower than study conducted in Eastern Ethiopia
whose finding shows that households believed that TM was 2.48 times cheaper than conventional
medicine and they were more likely to use TM [AOR=2.48 (P ≤ 0.072), 95% C.I. (1.21-5.08)] for
their sicknesses than those households who did not notice that TM was cheap and the same studies
shows that 41.80% of the respondents preferred TM because they spent less time before being
served as the TM users never had long waiting compared to conventional medicine this is slightly
lower than the findings of this study which revealed that 61.0% of the participants prefer the use of
tradition medicine because of its easy accessibility (Bussa & Gemeda, 2018). The difference might
be due the distribution of health care service in the Gambia might be different from distribution of
health care services in Eastern Ethiopia. In this study respondents who said Yes to far distance
from health facility are 1.056 times more likely to prefer traditional medicine than Respondents
who said no (AOR: 1.056, 95% CI: (0.334, 3.341) this is similar to the study conducted in Vietnam
which revealed that Logistics is again a deciding factor in people’s choice, since those who live
farther away (>2 km) from a commune health Centre tend to choose traditional medicine services
(OR = 2.17; 95 % CI 1.10– 4.29) (Tran et al., 2016).

37
 CHAPTER FIVE

5.6 CONCLUSION AND RECOMMENDATION

5.7 CONCLUSION
Improving the health status of the society is becoming the main policy agenda of many
countries and to improve health status of a country primary health care has to be
strengthened, therefore integrating traditional medicine into healthcare system will
improve the health status of a country. In conclusion the research aimed at determining
household preference to traditional medicine and the factors that influence household
preference to traditional medicine. The study revealed that more than half 64% of the
participants prefer to use traditional medicine. The findings of this research revealed
that there is strong association between households preference Affordability, religious
affiliation, distance from home, therapeutic effectiveness, cultural influence, and trust to

38
 traditional medicine were reasons for preferring traditional medicine. Marital status,
occupation, religion, and educational level were determinants of the preference and
practice of traditional medicine.

5.8 RECOMMENDATION
Therefore, policy makers should start considering traditional medicine and work toward
integrating traditional medicine into the national health care system. Traditional healers
should be train on scientific method of preparing traditional medicine so that traditional
healers can set right dosage for traditional medicine.
Policy makers should license tradition healers.

39
 This would increase the accessibility and affordability to health care services.

5.9 STRNGTH AND LIMITATION OF THE STUDY

5.6.1 Strength
This is one of the rare researches that focus on the study of traditional medicine
in urban center in this country; it identifies factors that influence household
preference to traditional medicine.
5.6.2 Limitation
Relatively small sample size, being cross-sectional in design, single site, and inclusion of only urban
population were the main limitations of the study.

40
REFERENCES

Abbo, C., Odokonyero, R., & Ovuga, E. (2019). A narrative analysis of the link between modern
medicine and traditional medicine in Africa: A case of mental health in Uganda. Brain
Research Bulletin, 145, 109–116.
Addis, G., Abebe, D., Genebo, T., & Urga, K. (2015). Perceptions and practices of modern and
traditional health practitioners about traditional medicine in Shirka District, Arsi Zone,
Ethiopia. Ethiopian Journal of Health Development, 16(1), 19–23.
Adorisio, S., Fierabracci, A., Rossetto, A., Muscari, I., Nardicchi, V., Liberati, A. M., Riccardi, C.,
Van Sung, T., Thuy, T. T., & Delfino, D. V. (2016). Integration of traditional and western
medicine in Vietnamese populations: A review of health perceptions and therapies. Natural
Product Communications, 11(9), 1934578X1601100949.
Agbor, A. M., & Naidoo, S. (2016). A review of the role of African traditional medicine in the
management of oral diseases. African Journal of Traditional, Complementary and Alternative
Medicines, 13(2), 133–142.
Chali, B. U., Hasho, A., & Koricha, N. B. (2021). Preference and practice of traditional medicine and
associated factors in Jimma Town, Southwest Ethiopia. Evidence-Based Complementary and
Alternative Medicine, 2021.
Gyasi, R. M., Mensah, C. M., Osei-Wusu Adjei, P., & Agyemang, S. (2019). Public perceptions of the
role of traditional medicine in the health care delivery system in Ghana.
James, P. B., Wardle, J., Steel, A., & Adams, J. (2018). Traditional, complementary and alternative
medicine use in Sub-Saharan Africa: A systematic review. BMJ Global Health, 3(5), e000895.
Nigussie, S., Godana, A., Birhanu, A., Abdeta, T., Demeke, F., Lami, M., Gemechu, K., Eyeberu, A.,
Bogale, K., Dechasa, D. B., Getachew, T., Negash, A., Aliyi, S., Meseret, F., Kibret, H.,
Nigatu, B. B., Dirirsa, G., Gebremariam, T. B., Bayu, K., … Dessie, Y. (2022). Practice of
Traditional Medicine and Associated Factors Among Residents in Eastern Ethiopia: A
Community-Based Cross-Sectional Study. Frontiers in Public Health, 10, 915722.
https://doi.org/10.3389/fpubh.2022.915722

41
Street, R. A., Stirk, W. A., & Van Staden, J. (2016). South African traditional medicinal plant trade—
Challenges in regulating quality, safety and efficacy. Journal of Ethnopharmacology, 119(3),
705–710.
TCAM.pdf. (n.d.).

42
43