Prevalence and factors associated with the use of alternative (folk) medicine practitioners in 8 countries of the former Soviet Union

BMC Complementary and Alternative Medicine

Martin McKee¹  Dina Balabanova¹  Bayard Roberts¹  Erica Richardson²  Ai Koyanagi³  Andrew Stickley³ 

[1] European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK;European Observatory on Health System and Policies, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK;Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge 141 89, Sweden

关键词: Prevalence;    Medical symptoms;    Rural residence;    Former Soviet Union;    Alternative (folk) medicine;   

Others  :  1230109
DOI  :  10.1186/1472-6882-13-83

 received in 2012-09-22, accepted in 2013-03-19,  发布年份 2013

【 摘 要 】

Background

Research suggests that since the collapse of the Soviet Union there has been a sharp growth in the use of complementary and alternative medicine (CAM) in some former Soviet countries. However, as yet, comparatively little is known about the use of CAM in the countries throughout this region. Against this background, the aim of the current study was to determine the prevalence of using alternative (folk) medicine practitioners in eight countries of the former Soviet Union (fSU) and to examine factors associated with their use.

Methods

Data were obtained from the Living Conditions, Lifestyles and Health (LLH) survey undertaken in eight former Soviet countries (Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine) in 2001. In this nationally representative cross-sectional survey, 18428 respondents were asked about how they treated 10 symptoms, with options including the use of alternative (folk) medicine practitioners. Multivariate logistic regression analysis was used to determine the factors associated with the treatment of differing symptoms by such practitioners in these countries.

Results

The prevalence of using an alternative (folk) medicine practitioner for symptom treatment varied widely between countries, ranging from 3.5% in Armenia to 25.0% in Kyrgyzstan. For nearly every symptom, respondents living in rural locations were more likely to use an alternative (folk) medicine practitioner than urban residents. Greater wealth was also associated with using these practitioners, while distrust of doctors played a role in the treatment of some symptoms.

Conclusions

The widespread use of alternative (folk) medicine practitioners in some fSU countries and the growth of this form of health care provision in the post-Soviet period in conditions of variable licensing and regulation, highlights the urgent need for more research on this phenomenon and its potential effects on population health in the countries in this region.

【 授权许可】

   
2013 Stickley et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]World Health Organization: WHO Traditional Medicine Strategy 2000–2005. Geneva: WHO; 2002.
• [2]Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD: Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J 2012, 12:45-56.
• [3]Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC: Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998, 280:1569-1575.
• [4]Su D, Li L: Trends in the use of complementary and alternative medicine in the United States: 2002–2007. J Health Care Poor Undeserved 2011, 22:295-309.
• [5]Pitetti R, Singh S, Hornyak D, Garcia SE, Herr S: Complementary and alternative medicine use in children. Pediatr Emerg Care 2001, 17:165-169.
• [6]Adams J, Lui CW, McLaughlin D: The use of complementary and alternative medicine in later life. Rev Clin Gerontol 2009, 19:227-236.
• [7]Saydah SH, Eberhardt MS: Use of complementary and alternative medicine among adults with chronic diseases: United States 2002. J Altern Complement Med 2006, 12:805-812.
• [8]Astin JA: Why patients use alternative medicine: results of a national study. JAMA 1998, 279:1548-1553.
• [9]Wu P, Fuller C, Liu X, Lee HC, Fan B, Hoven CW, Mandell D, Wade C, Kronenberg F: Use of complementary and alternative medicine among women with depression: results of a national survey. Psychiatr Serv 2007, 58:349-356.
• [10]Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM, Platin N, Kearney N, Patiraki E: Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005, 16:655-663.
• [11]Duggan J, Peterson WS, Schutz M, Khuder S, Charkraborty J: Use of complementary and alternative therapies in HIV-infected patients. AIDS Patient Care STDS 2001, 15:159-167.
• [12]Ernst E: Prevalence of use of complementary/alternative medicine: a systematic review. Bull World Health Organ 2000, 78:252-257.
• [13]Fisher P, Ward A: Complementary medicine in Europe. BMJ 1994, 309:107-111.
• [14]Ong CK, Høg E, Bodeker G, Burford G: Regional overview: European region. In WHO Global Atlas of Traditional, Complementary and Alternative Medicine. Text Volume. Edited by Bodeker G, Ong KC, Grundy C, Burford G, Shein K. Kobe, Japan: World Health Organization Centre for Health Development; 2005:109-116.
• [15]Yamashita H, Tsukayama H, Sugishita C: Popularity of complementary and alternative medicine in Japan: a telephone survey. Complement Ther Med 2002, 10:84-93.
• [16]Ernst E: Serious psychiatric and neurological adverse effects of herbal medicines – a systematic review. Acta Psychiatr Scand 2003, 108:83-91.
• [17]Karpeev AA, Goryunov AV, Tonkov VV: Russian Federation. In WHO Global Atlas of Traditional, Complementary and Alternative Medicine. Text Volume. Edited by Bodeker G, Ong KC, Grundy C, Burford G, Shein K. Kobe, Japan: World Health Organization Centre for Health Development; 2005:135-141.
• [18]Iarskaia-Smirnova E, Romanov P: Culture matters: integration of folk medicine in health care in Russia. In Rethinking Professional Governance: International Directions in Health Care. Edited by Kuhlmann E, Saks M. Bristol: The Policy Press; 2008:141-154.
• [19]Brown JV, Rusinova NL: “Curing and crippling”: biomedical and alternative healing in post-Soviet Russia. Ann Am Acad Pol Soc Sci 2002, 583:160-172.
• [20]Condee N: Folk medicine in Moscow: Russian remedies. Wilson Q 1988, 12:167-171.
• [21]Waters E: Medicinal plants in Soviet and post-Soviet Georgia. Eur J Herb Med 2001, 5:5-13.
• [22]Field MG: Noble purpose, grand design, flawed execution, mixed results: Soviet socialized medicine after seventy years. Am J Public Health 1990, 80:144-145.
• [23]Katsaga A, Kulzhanov M, Karanikolos M, Rechel B: Kazakhstan: health system review. Health Syst Transit 2012, 14:1-154.
• [24]Yurchenko O, Saks M: The social integration of complementary and alternative medicine in official health care in Russia. Knowledge Work Soc 2006, 4:107-127.
• [25]Wan TTH, Chukmaitov A: Social capital and use of folk and herbal medicine by older women in Almaty, Kazakhstan. Int J Publ Pol 2007, 2:217-234.
• [26]Balabanova D, McKee M, Pomerleau J, Rose R, Haerpfer C: Health service ulilization in the former Soviet Union: evidence from eight countries. Health Serv Res 2004, 39:1927-1949.
• [27]Balabanova D, Roberts B, Richardson E, Haerpfer C, McKee M: Health care reform in the former Soviet Union: beyond the transition. Health Serv Res 2012, 47:840-864.
• [28]Lekhan V, Rudiy V, Richardson E: Ukraine: health system review. Health Syst Transit 2010, 12:1-183.
• [29]Richardson E, Boerma W, Malakhova I, Rusovich V, Fomenko A: Belarus: health system review. Health Syst Transit 2008, 10:1-118.
• [30]Ibraimova A, Akkazieva B, Ibraimov A, Manzhieva E, Rechel B: Kyrgyzstan: health system review. Health Syst Transit 2011, 13:1-152.
• [31]Pomerleau J, McKee M, Rose R, Balabanova D, Gilmore A: Living Conditions Lifestyles and Health. Work package no. 26 (working paper no. 10). London: London School of Hygiene and Tropical Medicine; 2003.
• [32]Brown S: Use of complementary and alternative medicine by physicians in St. Petersburg, Russia. J Altern Complement Med 2008, 14:315-319.
• [33]Adams J, Sibbritt D, Broom A, Loxton D, Pirotta M, Humphreys J, Lui CW: A comparison of complementary and alternative medicine users and use across geographical areas: a national survey of 1,427 women. BMC Complement Altern Med 2011, 11:85. BioMed Central Full Text
• [34]Wardle J, Lui CW, Adams J: Complementary and alternative medicine in rural communities: current research and future directions. J Rural Health 2012, 28:101-112.
• [35]Penkala-Gawecka D: Korean medicine in Kazakhstan: ideas, practices and patients. Anthropol Med 2002, 9:315-336.
• [36]Phillips SD: Waxing like the moon: women folk healers in rural Western Ukraine. Folklorica 2004, 9:13-45.
• [37]Martinez LN: South Texas Mexican American use of traditional folk and mainstream alternative therapies. Hisp J Behav Sci 2009, 31:128-143.
• [38]Mishra SI, Hess J, Luce PH: Predictors of indigenous healer use among Samoans. Altern Ther Health Med 2003, 9:64-69.
• [39]Ngoma MC, Prince M, Mann A: Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania. Br J Psychiatr 2003, 183:349-355.