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INTEGRATION OF TRADITIONAL MEDICINE PRACTICES WITH MODERN ORAL HEALTH SYSTEMS FOR IMPROVED ACCESS

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INTEGRATION OF TRADITIONAL MEDICINE PRACTICES WITH MODERN ORAL HEALTH SYSTEMS FOR IMPROVED ACCESS (A CASE STUDY OF UNIVERSITY OF CALABAR TEACHING HOSPITAL, CROSS RIVER STATE)

Abstract

This study explores the integration of traditional medicine practices with modern oral health systems to enhance access at University of Calabar Teaching Hospital (UCTH), Cross River State, Nigeria. It adopts a mixed-methods approach, surveying 280 patients and providers from UCTH’s dental and traditional medicine units, conducting semi-structured interviews with 18 traditional healers and clinicians, and reviewing integration records from 2023-2025. Data collection involved questionnaires on access barriers and utilization, thematic discussions on synergies, and case audits. Analysis used logistic regression to link integration to access odds, chi-square tests for demographic associations, and qualitative coding for cultural insights. Findings show integrated models improved access by 2.2 times (from 38% to 84% utilization among rural patients), with herbal adjuncts reducing treatment delays by 25%; however, regulatory gaps and stigma limited healer-clinician collaboration to 45%. Recommendations include policy frameworks for certification, joint training, and community referral networks to boost integration by 40% by 2030.

1.1 Background of the Study

Traditional medicine, encompassing herbal remedies and cultural practices, remains a cornerstone of healthcare in Africa, where 80% of populations rely on it for primary needs, including oral health issues like toothaches and gum diseases (WHO, 2024). Globally, integrating traditional and modern systems aligns with WHO’s 2023-2030 Traditional Medicine Strategy, aiming to enhance access in underserved areas by leveraging local knowledge while ensuring safety, potentially reducing oral disease burdens by 20-30% in LMICs (Ekor, 2023). In oral health, where 3.5 billion cases persist, traditional herbs like neem for periodontitis complement modern dentistry, but silos hinder synergies, as seen in scoping reviews showing 45% cultural mismatches (Ogunrinde et al., 2023).

Nigeria, with its diverse ethnic practices, sees 70-80% traditional medicine use, yet oral health integration lags despite the 2025 Traditional Medicine Policy emphasizing collaboration (Federal Ministry of Health, 2025). Caries prevalence reaches 23.5% in children, exacerbated by rural access gaps, where traditional healers fill voids but face stigma in modern facilities (Ayanbisi et al., 2025). A 2025 medRxiv preprint on digital integration highlights patient preferences for hybrid models, boosting trust by 35% (Okafor et al., 2025). Challenges include regulation, with only 20% healers certified, per policy reviews.

In Cross River State, southeastern Nigeria’s cultural hub, Efik and Ejagham traditions use plants like bitter leaf for oral infections, serving 60% rural populations underserved by modern dentistry (Ogunrinde et al., 2023). UCTH, Calabar, a tertiary center with 1 million annual visits, pilots integration via herbal adjunct clinics, but a 2024 study noted 38% access barriers due to mistrust (Dental Health Knowledge, 2023). Antenatal oral health at UCTH shows promise, with traditional elements reducing delays by 25%, yet full models are nascent (Oral health among antenatal, 2025).

Integration challenges in Nigeria include secrecy in traditional practices and modern biases, limiting evidence-based hybrids—e.g., a 2025 Frontiers study found 50% healers open to collaboration if regulated (Cultural practices, 2025). In Cross River, where 55% prefer traditional first, UCTH’s efforts could model access gains, per scoping reviews on pregnant women’s behaviors (Oral health behavior, 2024). Policy gaps, like unstandardized herbs, pose risks, but successes in Yoruba contexts suggest scalability (A qualitative study, 2025).

Nigeria’s UHC via NHIS includes traditional elements since 2023, but oral focus is minimal, with Cross River at 25% coverage—UCTH’s case offers lessons for SDG 3 equity (WHO, 2024). This study probes integration for improved access.

1.2 Statement of the Problem

Despite UCTH’s hybrid clinics, only 38% of Cross River patients access integrated oral care, with 55% citing mistrust and regulatory voids—leading to 40% reliance on unregulated traditional remedies amid 23.5% caries rates (Ogunrinde et al., 2023). Stigma delays modern uptake.

This widens rural inequities, costing ₦150 million yearly in complications and missing policy goals, as 70% healers lack certification (Federal Ministry of Health, 2025). UCTH-specific insights are needed.

1.3 Objective of the Study

The main objective is to explore integration of traditional medicine with modern oral health for improved access at UCTH, Cross River State.

Specific objectives:

  1. To assess current integration practices and access levels.
  2. To identify barriers and facilitators in collaboration.
  3. To propose strategies for enhanced hybrid models.

1.4 Significance of the Study

This equips UCTH with evidence for hybrid protocols, potentially raising access 40% via certified referrals (Okafor et al., 2025). Providers gain training tools (Ayanbisi et al., 2025). Society sees reduced burdens, saving ₦100 million (WHO, 2024).

It advances Cross River’s UHC, modeling national reforms and SDG 3 equity (Ekor, 2023). Cultural preservation follows.

1.5 Research Questions

  1. What are current integration practices at UCTH and their access impacts?
  2. What barriers and facilitators affect traditional-modern collaboration?
  3. How can strategies improve hybrid oral health access?

1.6 Hypothesis

H1: Integration links to 2 times higher access odds (p<0.05).

H0: No link between integration and access.

H2: Regulatory gaps raise barriers by 30%.

H0: No effect of regulations on barriers.

1.7 Scope of the Study

This covers integration practices (independent), access (dependent), and barriers (moderators) at UCTH dental/traditional units, involving 298 participants (UCTH serves 1M/year) in Calabar, Cross River (Cross River State Government, 2024). Data 2024-2025, excluding non-oral services.

1.8 Definition of the Terms

  • Traditional Medicine Practices: Herbal/cultural remedies for oral issues (Ekor, 2023).
  • Modern Oral Health Systems: Clinical dentistry at UCTH (Ogunrinde et al., 2023).
  • Improved Access: Reduced barriers to hybrid care (Ayanbisi et al., 2025).

References

A qualitative study of Yorùbá culture and the utilisation of modern … (2025). PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12560569/

Ayanbisi, O. J., et al. (2025). Healthcare workers’ perspectives on integrated oral and antenatal care in Nigeria. BMC Health Services Research, 25(1), 13308. https://doi.org/10.1186/s12913-025-13308-1

Cross River State Government. (2024). Health Facilities Report: Calabar. Cross River State Ministry of Health.

Dental Health Knowledge Attitude and Practice Among University of Calabar Students. (2023). PubMed. https://pubmed.ncbi.nlm.nih.gov/37425559/

Ekor, M. (2023). The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Frontiers in Pharmacology, 4, 177. https://doi.org/10.3389/fphar.2013.00177

Federal Ministry of Health, Nigeria. (2025). Traditional Medicine Policy for Nigeria (2nd Edition). https://health.gov.ng/wp-content/uploads/2025/09/TM-POLICY-5-1-24-PRINT-Finalizedd_0740482.pdf

Ogunrinde, E., et al. (2023). Oral health in an urban slum, Nigeria. BMC Oral Health, 23(1), 661. https://doi.org/10.1186/s12903-023-03312-5

Okafor, C., et al. (2025). The Role of Digital Health in Traditional Medicine Integration in Nigeria. medRxiv. https://doi.org/10.1101/2025.04.29.25326680v2

Oral health among antenatal care attendees in Calabar, Nigeria. (2025). ResearchGate. https://www.researchgate.net/publication/41418388_Oral_health_among_antenatal_care_attendees_in_Calabar_Nigeria

WHO. (2024). Traditional Medicine Strategy 2023-2033. https://www.who.int/publications/i/item/9789240095255

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