This study explored the use of complementary and alternative medicine among the elderly in communities in Ebonyi State, Southeast Nigeria. It showed that almost all the participants believed that there are health benefits associated with the use of CAM. This is similar to findings from a study in Australia [25]. This widespread belief underscores the importance of CAM in the healthcare landscape and suggests a high level of acceptance and trust in its potential efficacy among the participants. In contrast, a study in Enugu, south east Nigeria observed that only a quarter of the respondents could describe specific benefits from the use of CAM [32]. This discrepancy might be due to differences in the methodologies of the studies.
The finding that the commonest condition for which CAM is used is febrile illness, ranging from malaria, and typhoid fever to hepatitis is contrary to the results from a study in Saudi Arabia, which reported musculoskeletal disorders, cardiac problems, and neurological problems as the primary health reasons for CAM use among the elderly [33]. The difference in findings may be due to variations in disease patterns between the regions, and this may be attributed to various factors, including environmental conditions, and access to healthcare services. In regions, such as the study area where infectious diseases are endemic or where access to conventional healthcare is limited, individuals may turn to CAM for managing acute illnesses such as febrile conditions. On the other hand, in more developed regions with aging populations, chronic conditions like musculoskeletal disorders and cardiovascular diseases may be more prevalent, driving the utilization of CAM for symptom management and holistic care.
The findings from our study suggest that the elderly commonly turn to CAM due to two primary non-medical reasons which are belief in its effectiveness, and lower costs. These findings further affirm an earlier study in another part of the state which reported that most older persons preferred alternative medicine to conventional medicine due to presumed efficacy and cost among other factors [24]. Also, the findings are consistent with similar studies conducted in Bangladesh, and Germany [34, 35]. The belief in the effectiveness of CAM reflects a common perception among the elderly population that these modalities offer therapeutic benefits beyond those provided by conventional medicine. This belief may stem from personal experiences, or cultural traditions, as many older adults have lifelong experience with alternative medicine due to unavailable conventional care during their childhood [36]. In addition, the perception of lower costs associated with CAM aligns with global trends of seeking more affordable healthcare options, particularly among older adults who may be facing financial constraints.
Another rationale for the use of CAM by the elderly as observed from our study is dissatisfaction with conventional health service delivery. There was a perception among most of the participants that there is poor quality of care in orthodox healthcare settings, such as delay in diagnoses and treatments. Such people believe that traditional healthcare services are quicker, and that CAM products act more swiftly compared to orthodox medicines. This further affirms the findings from previous studies in sub-Saharan Africa that one of the major reasons for non-use of health facilities is poor quality of care coupled with attendant delays in accessing care, often attributed to drug and equipment shortages, under-staffing, or poor infrastructure and poor attitudes among health workers. [37–39].
Further, few of the participants believed that certain diseases have spiritual origins and were better treated with some forms of CAM, such as rituals. Earlier studies in different parts of the country reported that certain disease conditions are considered incurable with western medicine because of belief in their spiritual origins and, as such, are only treated with alternative medicine [40, 41]. This finding is not unique to Nigeria, but was also reported in various parts of both the developed and the developing nations [42]. This finding reflects a cultural and religious perspective on health and illness that is common in many societies. The notion that certain diseases can only be addressed through alternative therapies due to their spiritual origins underscore the complexity of health beliefs and practices in the region. In Nigeria, several people believe that prayer alone can effectively address all their challenges, including sickness. As a result, a large number of people attend miracle healing services seeking relief from various health conditions [43]. This highlights the significant influence of religious beliefs on health-seeking behaviours, and the need to understand them in healthcare provision.
In spite of the widespread use of CAM among the participants, few participants raised concerns about lack of appropriate dosing and potential side effects. The finding is similar to a previous study carried out in Lagos, southwest Nigeria, and this suggests that the issue may not be an isolated one, but rather reflects a broader pattern across different regions of the country [17]. This lack of dosing could potentially lead to misuse or overuse of alternative therapies, which in turn may increase the risk of adverse effects. Thus, efforts should focus on promoting evidence-based practices, and strengthening regulatory measures to ensure the safe and effective use of alternative therapies.
The major limitation of this study is that it is not easy to generalize since this is a qualitative study. However, the use of FGD enabled an in-depth exploration of the perspectives of older persons in the communities, while data synthesis was based on Leventhal’s self-regulatory model which provided a theoretical framework for understanding the use of CAM among the elderly. Future research should explore the efficacy and safety of CAM therapies and their integration into mainstream healthcare practice.