Traditional and Complementary Medicine in Tanzania: Regulation Awareness, Adherence and Challenges

Document Type : Original Article

Authors

Department of Behavioural Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Abstract

Background 
The demand for and use of Traditional and Complementary Medicine (T&CM) has recently increased worldwide drawing a public health attention including malpractice, which puts the health of its clients at risk. Despite efforts made by Tanzania to integrate T&CM in the health system to protect the clients, regulating the subsector has remained a challenge due to lack of information and operational factors facing the regulatory frameworks in Tanzania. The aim of this study was to determine the extent of imperfect information, regulation adherence and challenges among T&CM practitioners and regulators in Tanzania.
 
Methods 
In-depth interviews were carried out with T&CM practitioners in Dar es Salaam Region in Tanzania, and officials from the Ministry of Health and the study municipals. Purposive and snowballing approaches were used to select study participants. Thematic data analysis was done with the help of NVIVO.

Results 
Awareness of regulations and tools used for regulating the T&CM operations among practitioners was generally very low. There was fragmentation of knowledge on what they were practicing as well as on awareness of the regulations, and what is regulated. Practitioners argued that they cannot be controlled by conventional medical trained personnel. Regulators at municipal level reported to have had no knowledge, interest, and time to work on T&CM. Lack of adequately trained and qualified manpower, lack of financial resources, poor transport and other infrastructure at the municipal regulatory units aggravated non-adherence to regulations, and therefore rendered ineffectiveness to the regulatory framework.
 
Conclusion 
Existence of imperfect information on T&CM among regulators and practitioners affect effectiveness of T&CM regulatory process. Awareness of regulations among practitioners, presence of knowledgeable regulators, as well as capacity would facilitate adherence to regulations.

Keywords

References

  1. Bodeker G, Kronenberg F. A public health agenda for traditional, complementary, and alternative medicine. Am J Public Health. 2002;92(10):1582-1591. doi:10.2105/ajph.92.10.1582
  2. World Health Organization (WHO). WHO Traditional Medicine Strategy: 2014-2023. WHO; 2013:1-76.
  3. World Health Organization (WHO). WHO Global Report on Traditional and Complementary Medicine 2019. WHO; 2019.
  4. Burton B. Australia backs tougher regulation for complementary health products. BMJ. 2005;330(7492):619. doi:10.1136/bmj.330.7492.619
  5. Alameddine M, Naja F, Abdel-Salam S, Maalouf S, Matta C. Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study. BMC Complement Altern Med. 2011;11:71. doi:10.1186/1472-6882-11-71
  6. Lunyera J, Wang D, Maro V, et al. Traditional medicine practices among community members with diabetes mellitus in Northern Tanzania: an ethnomedical survey. BMC Complement Altern Med. 2016;16(1):282. doi:10.1186/s12906-016-1262-2
  7. Stanifer JW, Patel UD, Karia F, et al. The determinants of traditional medicine use in Northern Tanzania: a mixed-methods study. PLoS One. 2015;10(4):e0122638. doi:10.1371/journal.pone.0122638
  8. Kayombo EJ. Traditional and alternative medicine in Tanzania: lesson from the exhibition. SAS J Med. 2017;3(1):23-31.
  9. Liwa A, Roediger R, Jaka H, et al. Herbal and alternative medicine use in Tanzanian adults admitted with hypertension-related diseases: a mixed-methods study. Int J Hypertens. 2017;2017:5692572. doi:10.1155/2017/5692572
  10. James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in sub-Saharan Africa: a systematic review. BMJ Glob Health. 2018;3(5):e000895. doi:10.1136/bmjgh-2018-000895
  11. World Health Organization (WHO). Trends in Maternal Mortality: 1990 to 2013 Executive Summary. WHO; 2014.
  12. Welsh S, Kelner M, Wellman B, Boon H. Moving forward? complementary and alternative practitioners seeking self-regulation. Sociol Health Illn. 2004;26(2):216-241. doi:10.1111/j.1467-9566.2004.00387.x
  13. Nicolai T. Complementary and Alternative Therapies for Patients Today and Tomorrow. Brussels: European Parliament; 2017.
  14. Kayombo EJ, Mahunnah RL, Uiso FC. Prospects and challenges of medicinal plants conservation and traditional medicine in Tanzania. Anthropology. 2013;1(3):1-8.
  15. Hwang T. FDA and the Challenge of Alternative Medicine: Realistic Assessments and Regulatory Flexibility. Harvard Library; 1997.
  16. Mbwambo ZH, Mahunnah RL, Kayombo EJ. Traditional health practitioner and the scientist: bridging the gap in contemporary health research in Tanzania. Tanzan Health Res Bull. 2007;9(2):115-120. doi:10.4314/thrb.v9i2.14313
  17. Spangler SA, Bloom SS. Use of biomedical obstetric care in rural Tanzania: the role of social and material inequalities. Soc Sci Med. 2010;71(4):760-768. doi:10.1016/j.socscimed.2010.05.025
  18. Bernard HR. Social Research Methods: Qualitative and Quantitative Approaches. SAGE Publications; 2000.
  19. Bowling A. Research Methods in Health: Investigating Health and Health Services. Maidenhead, Berkshire, England: McGraw Hill/Open University Press, 2009.
  20. Mills SY. Regulation in complementary and alternative medicine. BMJ. 2001;322(7279):158-160. doi:10.1136/bmj.322.7279.158
  21. OpenStax Economics: The Problem of Imprefect Information and Asymmetric Information. In: Principles of Economics. OpenStax CNX; 2016.
  22. Walker DR. Report on the Regulation of Herbal Medicines and Practitioners. Department of Health; 2015. https://www.bl.uk/collection-items/report-on-the-regulation-of-herbal-medicines-and-practitioners#.  Accessed June 6, 2021.
  23. World Health Organization (WHO). National Policy on Traditional Medicine and Regulation of Herbal Medicines: Report of a WHO Global Survey. WHO; 2005.
  24. Kumaranayake L, Mujinja P, Hongoro C, Mpembeni R. How do countries regulate the health sector? evidence from Tanzania and Zimbabwe. Health Policy Plan. 2000;15(4):357-367. doi:10.1093/heapol/15.4.357
International Journal of Health Policy and Management
Volume 11, Issue 8
August 2022
Pages 1496-1504

Files

History

  • Receive Date: 05 February 2020
  • Revise Date: 25 January 2021
  • Accept Date: 24 April 2021
  • First Publish Date: 09 June 2021

Share

How to cite

Statistics