Soc Sci Med. 1993 Apr; 36(8): 1023-35.

Enhancing appropriate drug use: the contribution of herbal medicine promotion. A case study in rural Thailand.

Le Grand A, Sri-Ngernyuang L, Streefland PH.

Primary Health Care Programme, Royal Tropical Institute, Amsterdam, The Netherlands.

The article presents the results of an exploratory study conducted in Thailand in 1988, comparing the results of two approaches to encourage the use of herbal medicine as a safe and cheap alternative to pharmaceuticals. The study included one government programme using a clinic-oriented approach and one non-governmental programme using a community-oriented approach. Drug use in response to illness episodes was surveyed among households in two villages covered by each programme and hospital out-patient prescription records were sampled. Herbal medicines were used to treat 14.8% and 14.0% of the illness-episodes in the villages taking part in the clinic-oriented programme and to treat 62.1% and 29.7% of the episodes in the villages covered by the community-oriented programme. Herbs are mostly used after a prior treatment with pharmaceuticals has failed. Only 12.4% of out-patient prescriptions from the hospital in the government programme included herbal drugs, compared to 47.3% of prescriptions from the hospital in the non-governmental programme. The results of the study suggest that a community-oriented approach can most effectively influence the pattern of drug use in self-care. Complementary to the community-oriented approach, the government should support efforts to change the prescribing attitude of physicians and include training in traditional medicine in medical curricula.