Association of healthcare access, demographic and psychosocial factors with herbal medicine use: a survey of paediatric and adult outpatients

Objectives Herbal medicine use is common in sub-Saharan Africa and might be influenced by several important factors. Therefore, this study assessed the association of healthcare access, socio-demographic and psychosocial factors with herbal medicine use. Design Cross-sectional design. Setting Three tertiary hospitals in Nigeria. Participants The study comprised 1250 outpatients who were clinically stable, provided informed consent and could communicate effectively. Patients who needed emergency/critical care or were mentally unstable were excluded. Primary and secondary outcome measures The primary outcome measure was the influence of variables such as healthcare access, demographic and psychosocial factors on herbal medicine use. Results The prevalence of herbal medicine use was 48.6%, and ethnicity was significantly associated with lifetime use (χ² = 37.905, p=0.036). Having tertiary education had non-significant but higher odds of herbal medicine use (OR=1.543; 95% CI 1.023–2.321; p=0.059). In multivariate logistic regression, which controlled for all healthcare access variables simultaneously, herbal medicines had over five times higher odds of being the first treatment choice (aOR=5.42; 95% CI 3.15 to 9.31; p<0.001). Preference for herbal/traditional care was a powerful predictor, doubling the odds of use (aOR=2.05; 95% CI 1.49 to 2.82; p<0.001). Perceiving healthcare as ‘not accessible at all‘ also showed significant associations (aOR=1.65; 95% CI 1.07 to 2.54; p=0.023), and the identification of long waiting times as a barrier also increased the odds of use (aOR=1.38; 95% CI 1.03 to 1.85; p=0.032). The psychosocial factors did not show statistically significant associations with lifetime use of herbal medicines. Conclusions Herbal medicine use was associated with ethnicity, healthcare accessibility and long hospital waiting times and was commonly the first treatment choice, highlighting a crucial need for structural and systematic integration of herbal medicine therapy into the healthcare system. Future studies may examine the barriers to successful integration in low- and middle-income countries to inform appropriate interventions.