Herbal Medicine Revisited 4/4
Knowledge of consumer satisfaction (CS) and analyses of its contributory role in the creation of a vibrant contemporary HM use culture might trigger strategic provider-initiated improvements in the provision of quality HM-based care. Yet research has neither examined its details nor explored its impact on the delivery of HM-based care in the increasingly market-driven HM-based health care industry in Ghana.
This blog summarizes key explanatory undercurrents of CS that could, in future, be well-grounded in survey responses. Juxtaposed against other areas of study, these observations can also receive consistent support from multiple lines of independent evidence across behavioral, scientific and socioeconomic levels of analysis – and not merely through survey study.
Building on earlier blogs that examined user socio-demographic features, a multi-dimensional picture of HM care in urban Ghana can now be constructed that accounts for consumer satisfaction (CS) and thereby offer users, providers, public health community and policy makers a comprehensive account of HM use culture in urban Ghana. HM is now consumer-centric and its contemporary use culture maintains strong user-friendly practices that has built considerable user loyalty. As a consequence, user feedbacks can be readily obtained via surveys and be speedily integrated into existing demography-based HM survey research to improve the quality of provided care and to offer better treatment outcomes for urban users.
Survey methods on CS will show that users have a high positive HM use outlooks including excellent perceived HM efficacy and outstanding perceived HM safety. Although labels are deficient in details, users will report high beneficial satisfaction from existing package labels and will assert that formulation package labels disclose useful information on the therapeutic; on the side effects; and on the dose of formulations. Additionally, users will assert that HM met their overall health expectations with beneficial use experience that triggered strong re-purchasing intentions and produced strong willingness to recommend HM formulations to others with similar or other symptoms.
Epidemiological-based surveys will assert that a wide variety of formulation options with varying efficacies are available for the management of the same and different disease conditions. A vast number of such formulations are easily administered and well-tolerated by users. Package presentation will be considered a major source of variation for formulations derived from the same extracts or formulations that contain the same botanical ingredients. But continuous detail-oriented improvement in package labeling is fundamentally needed to sustain gains and ensure long-term success.
TV and radio and print ads provided broad overviews of available formulations and recommendations from trusted peers often helped narrow the search for treatment options to specific formulations. Most formulations offer prophylactic therapy for loss of vitality and a relatively lower number of formulations target specific conditions such as malaria, constipation, asthma, diabetes and STDs including HIV and syphilis. Users, however, desire additional increases in the variety of formulation options to increase choice and to improve treatment outcomes.
Issues of HM’s relevance in an urban communities that has reasonable access to AM are addressed by the: 1) need-less than satisfactory treatment outcomes for AM-based care for some symptoms; 2) process-the easy and seamless augmentation of health-span with natural products with perceived minimal adverse side effects and by the 3) desire-the ultimate enhancement of the health-related quality of life that all desire and for which HM ads extols. A conceptual model informed by proposed survey studies will posit that rising prevalence of HM use in urban communities involve dynamic factors that converge on optimization of health and on improvement in the health-related quality of life.
User feedback or CS will highlight intractable challenges: short shelf-life of formulations; significant microbial load of formulation; dangerously high levels of sodium benzoate anti-microbial preservative; nebulous efficacy and safety perceptions; ineffectual and erratic dosage and irregular use frequencies. Contraindications are absent on labels and in package leaflet inserts; the exact chemical constituents of formulations are often unstated since bioactive constituents have not been isolated and chemically identified. Paradoxically, most users seem to be content with just the name of the herbal plant on the label.
A framework that facilitates better understanding of the socio-cultural and medical context in which HM use occurs can be developed to assist in the advancement of more effective and possibly culturally tailored solutions to problems associated with its use. Potential user suggestions for improvements in HM-based care will include: expansion of available recipes via new formulation-related research; improvement in the source availability of herbal plants via sustainable forest management; improvement in the rigors of its science base via methodological simplification; and reduction in treatment costs via low-priced products.
User purchasing patterns is yet to be associated with type and severity of symptoms and with user level of satisfaction with treatment outcomes. Users dislike for formulations that are bitter in taste is a logical consequence of their preference for oral mode of administration. Co-use of HM with AM is common within a culture of ambivalence and alcoholic bitters use among young adults is rife within a culture of neglect of problematic alcohol use.
Users’ high overall satisfaction with HM might influence changes in practice and in policy and additionally, stimulate national interest in HM use outcomes studies. High users’ satisfaction therefore presents new challenges and unprecedented opportunities. Challenges focus on the prevention of abuse and elimination of adverse effects from use as well as the minimization of fake and adulterated formulations. Opportunities concentrate on the enhancement of the translational science that will manage the transformation of safe and efficacious formulations into AM drugs to improve public health.
Given the popularity and ubiquity of HM use among the urban population, this study is consistent with Ghana’s intent to improve the nations' capacity to provide guidance for better HM care delivery to all. It also strengthens the strategic focus of Ghana to integrate HM and AM care facilities. HM will play an increasingly higher significant role in public health as identified bottlenecks are addressed. And effective user feedback will enhance the successful commercialization of this parallel medical system that is poised to converge with AM to fill significant unmet gaps in Ghana’s medical system.