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Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

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Integrating traditional medical practice with primary healthcare system in Eritrea

GebreMichael Kibreab Habtom
  • Corresponding author
  • Department of Public Administration, College of Business and Economics, University of Asmara, Asmara, Eritrea
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Published Online: 2015-01-30 | DOI: https://doi.org/10.1515/jcim-2014-0020


Background: The purpose of this paper was to assess the perceptions and attitudes of modern medical practitioners (MMPs) and traditional medical practitioners (TMPs) about traditional medical practice and to analyze the utilization of traditional medicine in Eritrea.

Methods: The data for this study were collected in a 10-month period from January to October 2004. A cross-sectional study was conducted in three sub-zones of Eritrea: Dekemhare, Ghinda, and Maekel. A total of 500 (250 each) MMPs and TMPs, and 1657 households were included in the study. Data were collected both by questionnaire and an interview (with key informants).

Results: Our study reveals that there is a significant difference in perception and attitude between MMPs and TMPs about traditional medical practice in Eritrea. Their differences lie not only in their way of thinking but also in their perceptions of man and health. Our study further shows that in most rural communities in Eritrea, the use of traditional medicine and self-care is extensive. This is the case even in the presence of the supposedly free/subsidized health care available in government health centers.

Conclusions: Higher confidence in traditional medicine for the treatment of serious illnesses, irrespective of availability of western medical service in many parts of Eritrea, indicates the need for selective integration of traditional medical practice with the primary healthcare system of the country.

Keywords: complementary; Eritrea; integrative; modern medical practitioners; traditional medical practitioners


  • 1.

    WHO. Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A World Wide Review. Geneva 2001.Google Scholar

  • 2.

    Eskinazi D. Factors that shape alternative medicine. J Am Med Assoc 1998;280:1621–3.CrossrefGoogle Scholar

  • 3.

    Bensoussan A. Complementary medicine – where lies its appeal? MJA 1999;170:247–8.Google Scholar

  • 4.

    WHO. General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine WHO/EDM/TRM/2000. 1, Geneva, Switzerland 2000.Google Scholar

  • 5.

    Muweh AN. Modernity in traditional medicine: women’s experiences and perceptions in the Kumba health district, SW region Cameroon. Master Thesis Submitted in Partial Fulfillment for the Award of Master of Science Degree in Public Health Sciences, 2011.Google Scholar

  • 6.

    WHO. Traditional medicine strategy 2002–2005. Geneva Switzerland: World Health Organization, 2002.Google Scholar

  • 7.

    WHO. Integrated care; position paper. Int J Integr Care 2001;1:1–16.Google Scholar

  • 8.

    Mander M, Ntuli L, Diederichs N, Mavundla K. Economics of the traditional medicine trade in South Africa. S Afr J Sci 2010;2010 Nov/Dec:98.Google Scholar

  • 9.

    World Bank. Eritrea: agricultural sector review (Draft Document). Washington, DC: World Bank, 2001.Google Scholar

  • 10.

    WHO. The world health report 2000. Health Systems: Improving Performance. Geneva: WHO, 2000.Google Scholar

  • 11.

    Hadas Eritrea, Tuesday 5, November 2002, 12th year, No. 46: A note taken from Eritrean National Statistics Office “Population studies”.Google Scholar

  • 12.

    World Bank. World development report. New York: Oxford University Press, 2000.Google Scholar

  • 13.

    UNICEF. The state of the world’s children 2004, New York: Oxford University Press, 2004.Google Scholar

  • 14.

    World Bank. World development report. New York: Oxford University Press, 2002.Google Scholar

  • 15.

    World Bank. World development report. New York: Oxford University Press, 2004.Google Scholar

  • 16.

    WHO. Declaration of Alma Ata: International Conference on Primary Health Care, Kazakhstan, 1978.Google Scholar

  • 17.

    WHO Traditional Medicine Strategy 2002–2005. WHO, Report. Geneva: World Health Organization, Manila, 1993, 2003.Google Scholar

  • 18.

    Jones S. The Eritrean public health program a model for rural Africa. N Afr Study 1991;13:7–17.Google Scholar

  • 19.

    Pankhurst R. An introduction to the medical history of Ethiopia. Trenton, NJ: Red Sea Press, 1990.Google Scholar

  • 20.

    Assefaw T, Gebremariam T, Melakeberhan D. Health needs assessment of the Eritrean nomadic communities, pastoral and environmental network in the horn of Africa (PENHA). Asmara, Eritrea: Ministry of Health, 1999.Google Scholar

  • 21.

    Papstein R. Eritrea: revolution at dusk. Trenton, NJ: The Red Sea Press, 1991.Google Scholar

  • 22.

    Desta Y. Does the EPLF (Eritrean people’s liberation front) qualify to be a learning organization? A modern systems theory perspective. J Organ Transform Social Change 2009;6:5–28. CrossrefGoogle Scholar

  • 23.

    Scherwitz L, Stewart W, McHenry P, Wood C, Robert L, Cantwell M. An integrative medicine clinic in a community hospital. Am J Publ Health 2003;93:549–52.CrossrefGoogle Scholar

  • 24.

    Government of Canada. Supporting self-care: A shared initiative 1999–2002. Health Canada, January 4, 2005, 2003Google Scholar

  • 25.

    Boon H, Verhoef M, O’Hara D, Findlay B. From parallel practice to integrative health care: a conceptual framework. BMC Health Serv Res 2004;4:15. Available at: http:/www.biomedcentral.com/1472-6963/4/15. Accessed 6 Jan 2005.Google Scholar

  • 26.

    Cohen MM. CAM practitioners and “regular” doctors: is integration possible? Med J Aust 2004;180:645–6.PubMedGoogle Scholar

  • 27.

    Murray D. Primary health care at the core of integrating and changing health systems. In: Walter De Gruyter: Six annual forum-primary health care in Canada, insight, information company, September 28–29, Courtyard-Marriot. Canada: Toronto, 2004.Google Scholar

  • 28.

    Williamson KD, Andrews GJ, Mitmaker L. Integrating complementary and alternative medicine with primary health care through public health to improve chronic diseases management. J Complement Integr Med 2005;2:1–23.Google Scholar

  • 29.

    Holman CDJ. Something old, something new: perspectives on five ‘new’ public health movements. Health Promot J Austr 1992;2:4–11.Google Scholar

  • 30.

    Beaglehole R. Challenging the public health workforce. Scand J Publ Health 2004;32:241–2.CrossrefGoogle Scholar

  • 31.

    Public Health in the Public Interest. The Canadian Coalition for Public Health in the 21st Century, Brief to the Senate Committee on Social Affairs, Science and Technology, October 2003.Google Scholar

  • 32.

    Primary Health Care Transition Fund, Evaluation Framework, May 28. Departmental program evaluation committee. Applied Research and Analysis Directorate. Information, Analysis and Connectivity Branch, Health Canada, 2004.Google Scholar

  • 33.

    White House Commission on Complementary and Alternative Medicine Policy. Final Report. March 2002. Available at: www.whccamp.hhs.gov/fr7.html. Accessed 2005 Jan.

  • 34.

    Fink S. International effort spotlight traditional, complementary, and alternative medicine. Am J Public Health 2002;92:1734–9.CrossrefGoogle Scholar

  • 35.

    Sarnat RL, Winterstein J. Clinical and cost outcomes of an integrative medicine IPA. J Manipulative Physiol Therapeut 2004;27:336–47.CrossrefGoogle Scholar

  • 36.

    Best A, Glik D. Research as a tool for integrative health service reform. Chapter 14 of. In Kelner, M, Wellman, B, Pescosolido B, M Saks, editors. Complementary and alternative medicine – challenges and change. Switzerland: Harwood Academic Publishers, 2000:223–38.Google Scholar

  • 37.

    Mwabu G, Ainsworth M, Nyamete A. Quality of medical care and choice of medical treatment in Kenya: an empirical analysis. J Hum Resour 1993;28:838–62.CrossrefGoogle Scholar

  • 38.

    MOH, Pharmaceutical Service Department. Preliminary assessment of traditional medical practitioners in Eritrea [unpublished document]. Asmara, Eritrea, 2010.Google Scholar

  • 39.

    Ghauri P, Gronhaug K. Research methods in business studies: a practical guide, 2nd ed. Harlow: Prentice Hall, 2002.Google Scholar

  • 40.

    Issayas S. Traditional beliefs and practices that affect the health of women and children in Eritrea. Asmara, Eritrea: UNFPA/UNICEF, 1996.Google Scholar

  • 41.

    Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States. Prevalence, costs and patterns of use. N Engl J Med 1993;328:246–52.PubMedCrossrefGoogle Scholar

  • 42.

    Murray RH, Rubel AJ. Physicians and healers – unwitting patterns in health care. N Engl J Med 1992;326:61–4.CrossrefGoogle Scholar

  • 43.

    McGuire MB. Ritual healing in Southern America. New Brunswick, NJ: Rutgers University Press, 1988.Google Scholar

  • 44.

    Cook C, Baiden D. Uncillary use of folk medicine by patients in primary care clinics in southwestern west Virginia. South Med J 1986;79:1098–101.PubMedCrossrefGoogle Scholar

  • 45.

    McGinnis LMS. Alternative therapies. An overview. Cancer 1991;67:1788–92.CrossrefPubMedGoogle Scholar

  • 46.

    Burgdorf WF, Happle R. What every dermatologist should know about homeopathy. Arch Dermatol 1996;132:955–8.CrossrefPubMedGoogle Scholar

  • 47.

    Leonard K, Zivin G. Outcome versus service based payments in health care: lessons from African traditional healers. NBER Working Paper Series. Cambridge, MA: National Bureau of Economic Research, 2003.Google Scholar

  • 48.

    National Statistics Office and ORC Macro. Eritrea Demographic and Health Survey (EDHS, 2002). Calverton, MD: National Statistics Office and ORC Macro, 2003.Google Scholar

  • 49.

    The American Heritage Dictionary of the English Language, 4th ed. Houghton: Muffing Company.Google Scholar

  • 50.

    Longman Dictionary of Contemporary English. Great Britain: Pitman Press, 1978.Google Scholar

  • 51.

    Oxford Advanced Learner’s Dictionary, 6th ed. Oxford: Oxford University Press, 2003.Google Scholar

  • 52.

    Good CM. Community health in tropical Africa: is medical pluralism a hindrance or a resource? In: Akhtar, R, editor. Health and disease in tropical Africa: geographical and medical view points. Switzerland: Harwood Academic Publishers, 1987:13–49.Google Scholar

  • 53.

    World Bank. African traditional healers: the economics of healing. IK Notes, No.32. 2001.Google Scholar

  • 54.

    Carroll TF. Social capital, local capacity building, and poverty reduction. Social development paper no.3. Bangkok, Thailand. Office of Environment and Social Development Asian Development Bank, 2001.Google Scholar

  • 55.

    Elujoba A, Odeleye O, Ogunyemi C. Traditional medicinedevelopment for medical and dental primary health care delivery system in Africa. Afr J Trad CAM, 20052005;2:46–61.Google Scholar

  • 56.

    Rukangira E. Medicinal plants and traditional medicinein Africa: constraints and challenges. Nairobi, Kenya: Sustainable Development International, 2005. Available at: www.conserveafrica.org

  • 57.

    Rappoport H, Rappoport M. The integration of scientific and traditional healing a proposed model. Am Psychol 1981;36:774–81.CrossrefGoogle Scholar

  • 58.

    MOH. Eritrea health profile. Asmara, Eritrea: MOH, 1999.Google Scholar

  • 59.

    National Statistics Office and ORC Macro. Eritrea demographic and health survey (DHS). Calverton, MD: National Statistics Office and ORC Macro, 1995.Google Scholar

  • 60.

    National Statistics Office (NSO) [Eritrea] and FAFO AIS. Eritrea population and health survey 2010. Asmara, Eritrea: National statistics Office and Fafo Institute for Applied International Studies, 2013.Google Scholar

  • 61.

    Habtom, G. K. Healthcare governance in developing countries: The case of Eritrea. [Ph.D. Thesis]. Tilburg, The Netherlands: Tilburg University Press, 2006.Google Scholar

About the article

Received: 2014-04-16

Accepted: 2014-11-17

Published Online: 2015-01-30

Published in Print: 2015-03-01

Citation Information: Journal of Complementary and Integrative Medicine, Volume 12, Issue 1, Pages 71–87, ISSN (Online) 1553-3840, ISSN (Print) 2194-6329, DOI: https://doi.org/10.1515/jcim-2014-0020.

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