Knowledge, Attitudes and Practices toward Traditional and Complementary Medicine among Nurses and Midwives in North Western Uganda

Abstract

Background: Traditional and complementary medicine also known in other countries as complementary and alternative medicine is steadily gaining popularity in all regions of the globe. Although it is widely known and accepted, studies show that the knowledge, attitudes and practices of conventional health care professionals toward it vary from one country to another. These variations have potential impacts on health outcomes. There is paucity of related literature in low income settings especially in Africa where this form of medicine is widely used with limited collaboration, integration and regulation. The aim of this study was therefore to assess the current knowledge, attitudes and practices of Nurses and Midwives in North Western Uganda towards traditional and complementary medicine in order to generate information that could be used to inform its policy and practice in Uganda and elsewhere. Methods: This was a descriptive cross sectional study that used quantitative methods of data collection and analysis. Self-administered structured questionnaires were administered to a sample of 300 Nurses and Midwives working in 6 selected public and private not for profit hospitals in the North Western region of Uganda. Data was processed and analyzed using Microsoft Excel and SPSS version 21. Results: It was found that the current level of knowledge among Nurses and Midwives in North Western Uganda on traditional and complementary medicine was very low. Nearly half (49.0%) had never heard of some traditional and complementary medicine therapies while 40.6% heard about some therapies but never knew their principles and only 10.4% knew how some therapies work. Most respondents (81.7%) had never been trained on traditional and complementary medicine in their years of clinical practice. It was also found that traditional and complementary medicine information was mainly obtained from traditional and non-evidence based sources such as mass media and oral tradition which may be misleading. Respondents’ attitudes were generally found to be good. Personal use was found to be common among the respondents with 54.9% having personally ever used it and 25.7% having used it in the past one year. Nurses and Midwives who had a traditional and complementary medicine provider in their family or had attended any training/continuing medical education on traditional and complementary medicine in their years of service or were working in hospitals in rural areas were found to personally use and recommend more traditional and complementary medicine to others. In addition, providing traditional and complementary medicine as a business and having served as health professional for more than 5 years were also independent predictors for the recommendation of such therapies to others. Nurse/midwife – patient communication on the use and effects of traditional and complementary medicine was found to be irregular, probably due to low levels of knowledge. Conclusions: Improving traditional and complementary medicine knowledge and practices among Nurses and Midwives and other health professionals could help to promote safer and rational use of traditional and complementary medicines. It could also avert human suffering arising from toxicities due to drug interactions and overdose as well as delayed seeking of appropriate health care. We therefore recommend on job training of conventional health workers on key aspects of traditional and complementary medicine, inclusion of traditional and complementary medicine use assessment as a key part of clinical evaluations and development of a traditional and complementary medicine health professional - patient communication strategy and guidelines for health professionals by the Ministry of Health. A course on traditional and complementary medicine needs to be included in the training curricula of all medical schools. Establishment or licensure of independent traditional and complementary medicine training schools to support training and research is also recommended. Integration of traditional and complementary medicine into the formal health care delivery system of the country could also help to streamline the regulation and standardization of its practice especially now when the little known complementary medicine therapies steadily penetrate the Ugandan health care market