Comparison of the prevalence of non-communicable diseases and traditional herbal medicine use in urban and rural communities in South Africa

Abstract

BackgroundTo quantify the use of traditional herbal medicines (THM), we documented the prevalence of specific health conditions, the use of THM and the influences and reasons for using indigenous treatment practices. MethodsA cross-sectional descriptive study using a homogenous purposive sampling among 721 South Africans living in rural and urban black South African communities. A structured questionnaire was used to collect data between April–October 2014 on clinical/medical history, health-seeking behavior, and Traditional Herbal Medicine (THM) use. Descriptive, bivariate and multivariable analyses was done using R. ResultsMajority of participants (77.5%) were from the urban area. More than (90%) had no health insurance, and 80% had monthly income of< R2000 (equivalent to $ 126) in both urban and rural areas. Most participants had NCD irrespective of location, but prevalence was higher amongst urban dwellers (61%). Hypertension was found to be the most dominant cardiovascular disease risk factor. Rural participants had statistically significant higher rates of hypertension (67.1%) and diabetes (32.1%). Use of THM was significantly associated with recommendations by family or colleagues. Participants who reported poorer health status in rural areas used THM more than those in urban areas. Using multiple logistic regression, rural participants have greater than 12-to-1 odds of being THM users than urban participants (odds ratio [OR]=12.62; 95% confidence interval [CI]=(4.09, 55.34)). ConclusionsNCDs were more prevalent in urban communities with hypertension being the most prevalent. There is widespread use of THM across South Africa. Rural residents and individuals of low social economic status rely more on THM. These findings suggest a need for systematic and larger studies to understand the magnitude and predictors of variation in access to and use of healthcare services, as these are critical to developing effective culturally appropriate interventions for approaching hard-to-reach patients. Helping patients navigate the complex healthcare system is the hallmark of a responsive system of care.