Kefa Bosire

The integration of traditional medicine into health systems is one of the major objectives of the current World Health Organisation (WHO) strategy on traditional medicine. This may be achieved through a multidisciplinary approach involving conventional health workers (CHWs) and traditional medical practitioners. Whereas the majority of studies have focused on the two groups, a few have prioritized the general public, a key stakeholder. The study aimed to investigate the public perception regarding the regulation and integration of herbal medicine (HM) into the mainstream healthcare system in Kenya. A cross-sectional study design was adopted, and a systematic random sampling strategy was used to select participants, who included one adult participant from each household within a span of 5 kilometres around each sampled public health facility, in Kakamega County, Western Kenya. A total of 317 adults were interviewed, and targeted structured questionnaires were used to obtain their perceptions on key relevant thematic areas, including use, efficacy, improvements of HM practice, and integration into mainstream healthcare. Statistical analysis was performed using IBM SPSS version 28.0. An assessment of support for integration was considered as the motivating objective. From the findings, 88% of the respondents reported that they use HM as part of their treatment when ill, 59% believe that HM provides effective treatment, and 78% believe they are safe. On integration, 52% of the public support integration of herbal and conventional medicine (CM), with 62% of the view that both medicines can be used concurrently. Notably, integration is already being informally implemented in Kenya, mainly through cross-referrals between HPs and CHWs, with 22% reported referrals by CHWs to HPs and 24% from HPs to CHWs. In conclusion, the proposed strategies of integration include cross referrals, registration and licensing of herbal practitioners (HPs), training HPs in modern healthcare practices, as well as documentation and validation of the efficacy of herbal medicines.

The practise of herbal medicine in Kenya is not well-regulated to date. This has resulted in infiltration by quacks and other malpractices that pose serious health problems to the Kenyan public. Additionally, despite treating the same patients in most cases, there is no communication between the medical staff and herbal practitioners, owing to the popularity of herbal medicine. The study aimed to understand herbalists’ opinions on regulation and the integration of their practice into mainstream healthcare. A cross-sectional study design was adopted, and purposive sampling was used to select participants, who included officials from the herbalist’s associations from 21 Kenyan counties where herbal practice is still rife. They comprised the chairman, secretary, treasurer, and organizing secretary for each association. A total of 70 officials who were willing to participate in the study were interviewed. Targeted structured questionnaires were used to obtain their views on several issues, including regulation, disclosure, and integration into mainstay healthcare. Data analysis was implemented using STATA version 13. The findings indicate that the majority (51%) of the herbalists are in support of local and national regulation through the Ministry of Health. Additionally, 99% are willing to work together with conventional healthcare workers by way of referrals. They are also willing to disclose their herbal medications to healthcare professionals (47%) and research institutions (87%). We propose an evidence-based model whereby herbalists are regulated under the Ministry of Health in order to eradicate quacks and malpractice. The herbalists may communicate with doctors by way of referrals and benefit from training from health officials.