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Gandu, Jacob Shekari Kura the Socio-Cultural And

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Gandu, Jacob Shekari Kura the Socio-Cultural And KADUNA JOURNAL OF POSTGRADUATE RESEARCH Vol.1. No:1. December, 2018, pp 225 - 240 GANDU, JACOB SHEKARI KURA Department of Sociology, Kaduna State University. THE SOCIO-CULTURAL AND ECONOMIC FACTORS INFLUENCING PATRONAGE AND UTILIZATION OF TRADITIONAL MEDICINE BY HEALTH CARE SEEKING CITIZENS IN KADUNA STATE Abstract: Individuals all over the world continue to utilize traditional health care, despite the increased availability of modern medicine (TM). In Africa, a vast majority of people have turned their attention to Traditional Medicine for their primary health care needs. However, there is very little understanding of why this is so. Findings on why this trend persists remain little understood and there is dearth of data from research on utilization of TM in Kaduna State. To enhance the understanding of the factors influencing utilization of TM in Kaduna State, the paper set out to examine the socio-cultural and socio-demographic factors influencing utilization of TM. A multi stage sampling method was applied such that both quantitative and qualitative methods of data collection were used. Findings indicate that cultural affinity, accessibility and efficacy are significantly determinants of patronage and utilization of traditional medicine in the study area. The users reported high levels of satisfaction that are attributable to procedural factors. Significantly the services of TMPS are filling the unmet gap left by modern health care in the state. The paper concluded that there is a need for Kaduna State government to properly integrate and blend traditional medicine on the modern medicine because such reinforcement will be of immense advantage to the sick and humanity in general. Keywords: Traditional medicine, Utilization, Socio-demographic, Health Care,Socio- cultural 1.0 Introduction Excellent health is basic to human existence. This explains why each society has over the years, evolved a pattern of healthcare to taking care of people with health challenges. It is a known fact that there are several ways by which people cure their ailments and this varies from one culture to another thereby making the health interventions and responses greatly different across cultures. Thus every society has a health care system that is indigenous to it. Traditional Medicine (TM) therefore, is used to describe a variety of indigenous health care practices employed by people of different societies and cultures. In general terms, both at the diagnostic and treatment levels, the operational platform of TM tend to focus on the overall condition of the individual patient or health seeker, rather than on the particular ailment or disease in question (WHO, 2002). For the purpose of this paper, 225 The Socio-Cultural and Economic Factors Influencing Patronage and Utilization of Traditional Medicine by Health Care Seeking Citizens in Kaduna State TM is seen as the sum total of knowledge, skills, and practices based on indigenous theories, beliefs, and experiences passed on to present generation by preceding generations for the purpose to maintain good public health, health care prevention, local health care diagnostic services and the treatment of physical or mental illnesses affecting people. Compared to modern medicine, TM seemed to enjoy a wider acceptability among various communities in Africa as an estimated 80% of Africans turn to TM when they needed primary health care (WHO, 2003a). Specifically, in Nigeria, Owumi and Taiwo (2012) averred that the Nigerian Primary Health Care is catering for less than 20% of potential patients, while traditional medicine caters for between 70 and 80 percent of various categories of Nigerians for the prevention, diagnosis and treatment of social, mental and physical ailments. Given the foregoing reality, this traditional health care has suffered relative neglect not only by Nigeria's national development planning architecture over the years, but by the nation's health care system development policies. Thus, requiring investigation why people still utilize the services of TM despite the government preference to modern health care. The idea of reflecting back to centuries-old-knowledge of herbal medicines used in treating or palliating numerous illnesses has validated its patronage and utilization. For example, the UNESCO (2013) noted that 30% of modern medicines (MM) are derived directly or indirectly from medicinal plants used by traditional practitioners. Examples of these medicines are analgesics (aspirin); anti-cancer medicines (vincristine and vinblastine); anti-hypertensive agents (reserpine) anti-malarial (quinne, artesimin) among others (WHO, 2008 and Paulo, Kofi, and Ossy, 2010). Also, the uprising of a number of research institutes like the Ahmadu Bello University, Zaria, and Pharmaceutical Research and Development of Nigeria (NIPRD) who are conducting research on TM for the treatment of malaria, HIV/AIDs, diabetes, sickle–cell anemia, and hypertension in order to produce evidence on their safety, efficacy, and quality has aided people's perception to utilization of TM. Apart from the afore mentioned, the practice of TM is a full time occupation and means of livelihood for some individuals, organisations and governments as there are various marketing strategies employed to warrant patronage. Couple with perception of illness causation, especially those caused by supernatural, natural and mystical factors, a great number of people in Kaduna State now patronizes TM with the hope of handling the challenges of witchcraft or evil machination of the generation. The belief that diseases and accidents have spiritual components and need to 226 GANDU, JACOB SHEKARI KURA be treated as such partly accounts for patronage of TM. For instance, Dada et al, (2011) document that many communities in Nigeria believe that sicknesses and afflictions usually have spiritual aspects and should be treated traditionally by spiritual intervention. This is evidenced in the work of Adefolaju, (2011:102) where he observes that services of traditional medical practitioners are relied upon by people because of the belief that they are vast in treating physical illnesses as well as psychological and spiritual comfort. Culture is considered first in their treatment regimens because tradition and cultural philosophy like norms, taboo and mores are pillars of clinical practice of TM (Ossey, Paulo and Kofi, 2010) Given that the medical fields are divided and labeled as modern and traditional medicine, culture becomes prominent and may thus influence people's perspective on what belongs to 'our culture' and the other culture and where to seek healthcare (Wreford 2005). Existing literature on relationship between socio-cultural standing of individuals and utilization of health care services pointed out that people with cultural bias have problems of access to modern health care facilities (Oyebola, 1980; Oke, 1995; Jegede, 1996; Owumi, (2005). This is so because the availability and accessibility of modern health care services placed them in difficult situation such that traditional healers become their last places of treatment. For instance, studies by Ogunlusi, Okem and Oginni (2007), Dada et al (2011) and Owumi, Taiwo and Olorunnisola, (2013) discover that easy access, quick service, cultural belief, utilisation of incantations and concoction, pressure from friends and families were major reasons for the patronage of TM. On cultural grounds, traditional healers do not charge much because there is a strong conviction and belief that the spirits will desert the treatment centres and make the medicine powerless, and in some cases, make the practitioners go mad or die when monetary rewards become the primary drive (Chris and Kwarja, 2011). The main objective is to find out how socio-cultural and socio-demographic factors influence the use of Traditional medicine in Kaduna State. Another objective is to examine how illness perceptions of the patients affect the use of Traditional medicine as their source of health care management. Methodology: The location of this study is Kaduna State which has an estimated population of more than 6.4 million people; spread across 23 Local Government Areas (LGAs) (National Population Commission (NPC), 2006). The research was conducted in two selected Local Government Areas (LGAs) from each of the three Senatorial Zones of the State, thereby making six LGAs in all. 227 The Socio-Cultural and Economic Factors Influencing Patronage and Utilization of Traditional Medicine by Health Care Seeking Citizens in Kaduna State The study population include, selected traditional healers, people who patronizes or have ever used the services of traditional healers, relatives of those who patronizes or have ever patronize the services of traditional healers, community leaders, representatives of religious organizations. A multistage sampling technique was used in this research. The first stage involved taking on all the three existing Senatorial Zones as clusters. The second stage involved selecting two LGAs predominantly rural through simple random sampling technique thus representing all the clusters in the categorization stated earlier. The third stage was the selection of Wards using the same procedure. One large town was purposively selected from each zone to make a total of three large towns. The large towns selected were Zaria, Kaduna and Kafanchan. In all a total of 1242 respondents were sampled for the survey and purposively 93 clients of traditional healers, 57 traditional healers of different areas and
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