KNOWLEDGE, ATTITUDE AND USAGE OF TRADITIONAL

MEDICINES AMONG OLDER PERSONS IN ALIMOSHO

LOCAL GOVERNMENT m

BY

OMOTOSHO, JOSEPH FOLA

(00-9F-01B-075)

BEING A PRE-FIELD SEMINAR IN PARTIAL FULFILMENT

FOR THE AWARD OF DOCTOR OF SOCIAL WORK OF THE
FACULTY OF SOCIAL SCIENCES,

DEPARTMENT OF SOCIOLOGY,

LAGOS STATE UNIVERSITY, OJO.

SUPERVISOR:
PROF ELIAS WAHAB

CO-SUPERVISOR:
PROF. AJIBOYE

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ABSTRACT
Nigeria ageing population has been on the increase in the recent past, with the
aging more marked in rural areas. Older persons account for more than 15% of
the population in the rural areas. However, the access and range of services
available to them in rural areas is limited with difficulties experienced in terms
of workforce, recruitment, retention and training, distance to services which is
complicated by lack of adequate and effective transport system and lack of
provision of residential aged care services. Over 65% of the Nigerian population
who live in the rural areas are most neglected and deprived of modern
healthcare services as well as other modern infrastructural facilities considered
essential for the maintenance and promotion of good health. This experience
has not only helped to sustain the use of herbs but makes traditional medicines
strive particularly among older persons seeking health care in the rural areas.
Triangulation method will be used for data collection. A multi-stage sampling
procedure will be adopted to select six hulondred (600) respondents. The aim
of this data collection is to elicit the prevalence of traditional medicines
knowledge, attitude and usage among older persons in the rural areas vis a vis
modern day medicines.

KEY WORDS
Traditional medicines, older persons, Healthcare Services, Rural Areas,
Orthodox medicine, Elderly, Health.

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CHAPTER ONE: INTRODUCTION TO THE STUDY

Introduction
Social scientists do not believe that age and ageing process is linked to
biological and psychological development but they cannot be fully understood
without reference to their social context. Just as race or sex were once seen in
purely biological and psychological terms but now viewed sociological through
concepts over as ethnicity and gender, age can also be seen in sociological
terms. From the perspective, age can be seen, as in part, a social construction.

The concept of age varies from culture to culture. In the traditional societies,
older persons are received and respected for their wisdom and have high social
status and considerable power (Haralamboset all, 2008).

At this particular stage, most older persons might have been disengaged from
their erstwhile life-long activities, sound health, poverty, emotional and material
neglect are some of the major challenges faced by older persons especially
when their family members are nowhere to be found in terms of support.

Most developed countries of the world have accepted the chronological age of
65 years on a definition of the “elderly” or older persons, but like most western
practices, this does not adapt well to the situation in Africa (WHO 2014).

Age classification varies from society to society but most of it is a reflection of

the political and economic situations of countries, which could also include life-
expectancy of the people of the country. Many a time this definition is linked to
retirement age, which in some instances, was lower for women than men. The
changes in means of livelihood became the basis for the definition of old age
which occurred between 45 and 55 years for female and between age 55 and 75
for men (Thame, 1978).

A single definition, such as chronological age or social cultural functional

markers etc is commonly used, among others by demographers, sociologists,
anthropologists, economics and researchers, it seems more appropriate in Africa
to use a combination of chronological functional and social definitions. Despite
the fact that Nigeria is considered and classified among developing countries, it
still maintains the definition of 65 years for an older person.

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It is noteworthy that because of the deplorable condition of older persons in the
society, accessibility, affordability and availability of modern day healthcare
delivery services may become a mirage. Older persons in our modern day
society and culture suffer after neglect when it comes to accessing modern day
health care and they have therefore resorted to using traditional medicines
which are readily available, affordable and accessible. Their beliefs in the
efficacy of traditional medicines to take care of their various disease conditions
has therefore become undeniable.

Although traditional medicines may still be shrouded in secrecy and

preservative method is far from being accurate, yet the elderly prefer them to
orthodox medicine.

This study will therefore examine the reasons or otherwise the elderly might
want to prefer the use of traditional medicine to modern day medicine in
Alimosho rural area
According to WHO, old age is classified into:
-Young old 60 -69 years
-Old old 70 -74 years
-Oldest old 75 -79 years
-Frail old 80 and above
The population of older persons is on the increase worldwide despite the fact
that life expectancy of human beings in developing countries like Nigeria is
lower than that of the developed countries.
The number and proportion of people aged 60 years and above in the population
is increasing. In 2019,the number of people aged60 years and above was over 1
billion population. This number will increase to 1.4 billion by 2030 and 2.1
billion by 2050. This increase is occurring at an unprecedented pace and will
accelerate in the coming decades, particularly in developing countries. The
historically significant change in the global population requires adaptation to the
ways societies are structure across all sectors. For example, health and social
care, transportation, housing and urban planning. Working to make the world
age friendly is an essential and urgent part of our changing demographics.
In many develop countries, older persons have access to social supports
(Okunade, 2014). However, in many countries including Nigeria hae no
comprehensive healthcare supports available for the older persons population
(Adisa, 2019). Older persons like any other members of the society,
playmajorrolesin the society. They are parents, brothers, sisters, grandparents,

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friends, neighbours and members of volunteer organisations and many of their
satisfactions and most help and supports come from social networks (Wenger,
2021).
Furthermore, Wahab (2013) notes that old age are not only specialized concern,
but also a process that affects the daily life and necessitates actions on the par of
the individual, family and community.
The older persons population around the world has sparked substantial
multidisciplinary research into a variety of health effects (Lloyd-Sherlock et
al.2012). Therefore the expanding numbers of older persons will probably result
into a greater need for understanding of the use of alternative medicines in the
treatment of their ailments. The World Health Organisation defines health as a
complete state physical, social and mental wellbeing and not merely the absence
of disease or infirmity (World Health Organisation,1948)
According to Amoo et al (2020), older persons with health challenges such as
arthritis, mental illness, hearing impairment, fractures frequently experience
significant burdens and impairments, older people are frequently misunderstood
as a normal part of aging and thus go unreported, undiagnosed and untreated.
Studies have shown that the health issues of the older persons have become
more serious in recent times as a result of rapid urbanization - a large number of
older people migrate to the cities to care for the younger generation such as
brand children, thereby posing a threat to their normal life due to poor and
social adaptability (Huang et al, 2019;Lu et al, 2021). On the other hand, those
who do not migrate to cities with their children are left behind and are more
likely to suffer from loneliness and ultimately death (Zhang,2021). Therefore, it
is imperative to conduct more research works on the healthcare of older persons
especially in Alimosho Local Government Area to improve their quality of life.

Advances in modern day medical science has contributed to this phenomenon

which had seen the population of the Western world to age gracefully and
constitute an old population which the developing countries having a young
population due to high fertility rate and lower life-expectancy.

Good health denotes the way one accesses the healthcare delivery service in
order to survive but also connotes the current condition of individual and
household and the ways and means via which they cater for themselves.

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Some other factors that can affect the healthcare of older persons include:-
relative wealth, poverty, neglect, access to resources to ensure longevity for
older persons.

Statement of the problem.

In spite of the enormous challenges facing ageing of the population all over the
world, globally, demographic patterns across all nations have changed
considerably over the past century, rapid declines in fertility and mortality rates
along with substantial improvements in. health care systems have resulted in the
growth of older populations around the world, particularly in the developed
nations of the world (Giang and Wade, 2009). The ageing of the world
population has been predicted to increase unabated, most especially in
developing countries without corresponding growth or increase in welfare
provisions that can help mitigate the social concomitant effects of the growth
particularly on the overall health of older persons category who are already
vulnerable.

Economic security, health and disability, and living conditions in old age are
policy concerns throughout the world, but the nature of the problems differs
considerably from continent to continent and between and within countries. The
experiences of the developed countries may not be of any significant help to the
developing societies due to cultural differences in this regards. Evidences have
shown that, throughout most of the developing world, providing support for
older people is still primarily a family responsibility. Traditionally, in sub-
Saharan Africa, the main source of support has been the household and family,
supplemented in many cases by other informal mechanisms, such as kinship
networks and mutual aid societies. According to Gillian, Turner, Bailey and
Latulipe, (2000), apart from very few countries in Africa, formal pensions or
other social welfare schemes are virtually nonexistent and where they do exist,
only a very few percentage of older persons population, about 5% benefits and
it covers only a small fraction of the elderly population who worked in the
formal. sector of the economy, hence, the majority have no access to formal
social security systems and this has created very serious problems for the
elderly categories, most especially, those that live in the rural areas of the
developing countries.

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Older age is also characterized by the emergence of several complex health
states that tend to occur only later in life and that do not fall into discrete disease
categories. These are commonly called geriatric syndromes. They are often the
consequence of multiple underlying factors and include frailty, urinary
incontinence, falls, delirium and pressure ulcers. Geriatric syndromes appear to
be better predictors of death than the presence or number of specific diseases.

It should be mentioned at this juncture that, before the ppintroduction of

orthodox medicine in Nigeria, traditional medicine was the system of health
care delivery. The knowledge of the various herbs, animals and minerals that
possess curative and palliative effects were transmitted from one generation to
another. This practice is known as ethno medicine, that is, the traditional health
care practice of indigenous people. Traditional healing and medical practices
included herbalists, divine healers, soothsayers, traditional midwives,
spiritualists, bone-setters, mental health therapists and surgeons. In spite of
more than 150 years of introduction of Western style medicine to Nigeria,
traditional healing and medical practices remain a viable part of the complex
health care system in Nigeria till date. Traditional herbal medicines are
naturally occurring; plant-derived substances with minimal or no industrial
processing that have been used to treat illness within local or regional healing
practices. Traditional herbal medicines are getting significant attention in global
health debates.

Herbal medicines have been widely utilized as effective remedies for the
prevention and treatment of multiple health conditions for centuries by almost
every known culture. Today, the populations of certain countries still depend on
herbal medicines to address their healthcare needs. The use of herbal medicines
continue to grow globally and most especially in the developing countries
where availability, accessibility, and affordability of modern medicine facilities
are still the main challenges of the rural populace. In rural Southwest, Nigeria,
elderly people are faced with how to cope with paradox of dwindling financial s
resources, increased health challenges and a high cost of medical expenses: In
particular, older persons living in rural southwest, Nigeria, reportedly utilized
health services when they are available, accessible and affordable which may
not be unconnected with the renewed patronage of herbal medicine among
elderly in rural Alimosho Local Government, Southwest, Nigeria.

Research Questions.
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1 What is the state of health of the older persons in Alimosho Local
Government Area , Lagos State?

2 Are there enough health care facilities specifically designed to cater to the
older persons in the events of sickness or disease conditions in the Local
Government?

3 Of what relevance is the use of herbal medicines to the older persons in

Alimosho Local Government area of the state?

4 What are the policies designed to cater to the older persons in Alimosho
Local Government Area of the State?

5 What is the attitude of both Lagos State Government and Alimosho Local
Government towards making the older persons access and enjoy sound health?

Objectives of the Study

The general objective of this study is to investigate into the nexus of interaction
between the use of herbal medicines and the health of the older persons in
Alimosho Local Government Area of Lagos State.

Other specific objectives of the study are to:

1. Examine the health status of the older persons in Alimosho Local
Government Area of Lagos State.

2. Identify the various health facilities available for the older persons in
Alimosho Local Government Area in the event ofsickness or disease
conditions.

3. Investigate the relevance of herbal medicine in modern healthcare of the

older persons in Alimosho Local Government Area of Lagos State.

4. Investigate the factors responsible for the continuous patronage of herbal

medicine among older person in Alimosho Local Government Area of
Lagos State despite of the availability of modern medicine.

5. Find out the various government policies on the healthcare of the older
persons in Alimosho Local Government Area of Lagos State.

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6. Examine the attitude of the Government towards traditional medicine
practices in Lagos State.

Significance of the Study

There are many research works that have been carried out on the usage of
traditional medicines among older persons in the Nigeria in the past but
not all of them have been exhaustively discussed taking the involvement
of social worker into cognizance hence the challenges still facing the
older persons in the community.
Therefore, the findings of this study will help the older persons to understand
and become aware of the importance of adequate knowledge, attitude and
usage of traditional medicines and possible adverse effects of traditional
medicines in the Alimosho Local Government.
Moreover, this study is necessary to help in the formulation of programs and
policies that will address the needs of the older persons and on the need to
build quality health-care delivery system for the older persons in the local
government.

Similarly, it will add to the existing body of knowledge in the field of

gerontology and healthcare of older persons through data, review of existing
literature and recommendations that will be preferred in the course of the study.
Another important and significant contribution of this study is to fill the gap in
knowledge.

It is also significant in knowledge advancement and methodological

advancement in this field.

Scope of the Study

For the purpose of the study, the scope of the research work would be an
examination of the preference of older persons in Alimosho Local Government
for traditional medicines against orthodox medicines and equally investigate the
adverse effects such drugs might have on the older persons and how to mitigate
such problems.

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l knowledge, attitude and usage of traditional medicines among the Old persons
in Alimosho Local Government Area, Lagos State.
Old age in this concept is believed to begin from age 60 years and above.
However, this age bracket changes from one culture to another.
For the purpose of this study, this will be broken down as follows:
-Young Old 60 -64 years
- Old age. 64-69 years
- Old old. 70 -74 years
- Oldest old. 75-79 years
- Frail elderly. 80 years and above.
The age, gender, marital status and educational attainment will play major role
in the knowledge, attitude and usage of traditional medicines among the older
persons.
It is believed that female, married, literate and youngest old persons patronise
traditional medicines more than any other age group.
Knowledge: their knowledge about the efficacy of traditional medicinal
medicine will definitely affect their attitude towards traditional orherbal
medicines.
Attitude: their attitude about traditional medicine will be contingent upon
upon their knowledge and consumption of traditional medicine. This stems from
their past knowledge of herbal medicine.
Usage: their continuous usage of traditional medicine is borne out of their
knowledge, attitude and efficacy of traditional medicines.

Literature Review and Theoretical Framework

In Nigeria, older persons Health has been an aspect that requires maximum
concentration as limited policy and social security has not been propagated
(adequate) in its systems (Adedoyin, Olatona, and Odeyemi, 2018). Over the
years in Nigeria, care and support for the older persons have been a
responsibility that rests on the family members, especially children, as most of
them rely on their relatives for both health and social care (Okumagba, 2011;
Shofoyeke, 2014). However, older people's lives in Nigeria have been subjected

9
to inadequate customary family support, social exclusion, and limited social
security (Shofoyeke, 2014).

Although, Nigerian society like many other developing countries have paid little
or no attention to the health conditions of the older persons, this is evident in the
inappropriate implementation of health care and social security required by this
category of persons (Fajemileyin and Odebiyi, 2011). In their works on Health
Infrastructure Inequality and Rural-Urban Utilization of Orthodox and
Traditional Medicines in Farming Households of Ekiti State, Nigeria,
Mafimisebi and Oguntade (2011) found access to health facility in the state with
68.9 percent but were higher in urban areas than rural areas. They also found
urban farmers spent more on both traditional and orthodox medicine than rural
farmers. The study further revealed that, 91.7 percent of the household heads in
the rural areas prefer traditional medicine for the treatment of ailments that are
not life-threatening. They reported inadequate access to health care in the study
area. Eneji et al. (2013) carried out a study on health care expenditure, health
care status and national productivity in Nigeria. They found health spending in
Nigeria is low and as such there is inequality in health care access in Nigeria.
They attributed poor health status in Nigeria to poverty and unemployment,
poor living conditions, ignorance and poor health behaviors, scarce health
resources and infrastructure and low government expenditure on health.

In a similar way, Fetus (2014) investigated the relationship between health

capital and poverty reduction in rural Cross River State, Nigeria. The study
found a positive relationship between health capital variables (health care
demand, accessibility and affordability of health care and proportion of
household income dedicated to health care) and rural poverty reduction. Fetus
(2014) also reported inadequate access to modern health care practitioners and
financial problems as constraints to health care service delivery in rural Nigeria.

Adeoti and Awoniyi (2014) analyzed demand for health care services and child
health status in Nigeria using a control function approach. They found gender of
child, mother's educational status, household size and sector impacts
significantly on the child's health status.

Gap in Literature

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However, there is a dearth of studies on their nexus of
intervention between traditional medicines and the health of
old people in the rural Alimosho, Southwest, Nigeria.
This is what this study is out to achieve.

Theoretical Orientations

Andersen Healthcare Utilisation Model

This paper will adopt the Andersen's Health care utilization model. The theory
explained the reasons for the continued patronage of herbal medicines in spite
of the orthodox medicine in modern day health care.

The model identifies three categories of factors:

1. Predisposing Characteristics: They include "demographic, social-

cultural and attitudinal-belief variables" that cumulatively influence the
likelihood of an individual accessing the health system in case of sickness
(Andersen and Newman 1973; Rebhan 2008; Reibling and Wendt 2008).
The variables exist before the occurrence of any medical condition.
Examples of predisposing characteristics are Sex (demographic),
education (social cultural) and perceptions about diseases (Reibling and
Wendt 2008). An individual that finds health services useful for treatment
will utilize these services.

2. Enabling Characteristics: Are factors that make sources available to

individuals such as income, insurance coverage and care available within
the community. The variables are not individual-based but on the level of
family, household or community (Andersen and Newman 1973 cited in
Reibling and Wendt 2008).

3. Ultimate Reason For Healthcare Utilization Need is the ultimate reason

for health care utilization and therefore refers to the actual adverse
medical condition experienced by an individual and clinically judged
severity of this illness.

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 The above mentioned factors are complemented by characteristics of the
health delivery system both in the rural and urban settings namely; (1)
Resources refer to health personnel and material (equipment, building
etc.) resources which are available in a health system. The level of
availability and distribution of the resources affect accessibility; and (2)
Organization is divided into entry and structure. The factors influencing
the "entry" to care are time spent traveling to and waiting time at the
healthcare facility (Rebhan 2008). The structure relates to the regulations
guiding who treats and how the patient is treated. The model was updated
by Andersen (1995) to capture consumer satisfaction and its effect on
health care utilization. Therefore, the model identifies the several health
services available and both the type of available services (that is, a
hospital, dentist, pharmacy or faith-based clinics) and the purpose of
health care service (that is, primary, referral care) will determine the type
of service available and utilized (Andersen 1995; Rebhan, 2008).

Health Seeking Behaviour.

Health Seeking Behaviour (HSB) has been defined as any action or
inaction undertaken by individual who perceive him or her sef to have a
health problem or to be ill for the purpose of finding an appropriate
remedy.

Huber et al. (2011) in his works corroborated WHO definition of health where
he proposed an extensive definition of health as 'the ability to adapt and to self-
manage' which includes the capability of individual persons to adapt to
condition and monitor their situation as key to health. It embraces the subjective
appraisal of health; as the meaning of health and well-being differs from one
individual to another (Crinson, 2007; Khan, 2017). According to the National
Council on Ageing, about 92% of the Elderly suffer one chronic disease that
affects their health condition, and 77% are reported to have more than one
chronic disease. Over the years, various health-related issues have been outlined
as mostly about aging and often occurring in the old-age and amongst older
person (UNFPA, 1999; Shofoyeke, 2014), ranging from dementia, rheumatism,
arthritis, heart disease, diabetes, High-Blood Pressure etc. In most cases, the
health challenges have a prominent effect on their life qualities, affecting older
person holistic well-being, physical strength and wellness (Chen and Feeley,
2014; Chang, Wray and Lin, 2014). Furthermore, these various health-related
12
issues can be categorized into chronic health conditions (such as, heart diseases,
cancer, stroke, diabetes, etc.), cognitive health issues (dementia and memory
loss), psychological (depression, disorder...), physical health issues
(osteoporosis and osteoarthritis, above bruising and fracturing, frailty), sexually
transmitted diseases, malnutrition, sensory impairments, oral health issues
(cavities, tooth decay, dry mouth, gum disease and mouth cancer), constipation
and bladder control challenges, among others (Muhammed, Sibgha, Mushtaq,
and Javed, 2017). Other major health-related issues include infectious and
communicable diseases (Muhammed, Sibgha, Mushtaq, and Javed, 2017).

However, various factors including the social, economic, psychological,

biological, natural, environmental, behavioural, nutritional have been identified
in the literature as having a continuous unrelenting influence on Elderly's health
(Koji, Takayuki, Masatomo, Yuniko, Kazuhiro and Yasuaki 2017).

2.3 Conceptual Framework

1. Traditional Medicine (TM): Traditional medicine comprises medical
aspects of traditional knowledge that developed over generations within
the folk beliefs of various societies, including indigenous peoples, before
the advent of modern medicine.

2. Older Persons: An older person is defined by the United Nations as a

person who is over 60 years of age. This can be male or female.
However, the concept of old persons differ between cultures.

3. Healthcare Services: Any service that can contribute to improved

health or the diagnosis, treatment and rehabilitation of the sick
individuals. It is not necessarily limited to medical or healthcare services.
Healthcare services are formally organized as a system of established
institutions and organizations to supply services to respond to the needs
and demands of the population within a defined financial and regulatory
framework. Healthcare services include health education, health
promotion, environmental services such as houses, sanitation which have
a known health benefit.

4. Rural Areas: An open swath of kind that has few homes or buildings
and not very many people. The population density of rural areas is very
13
 low. Many people live in cities or urban areas, where businesses are
located very close to one another.

5. Orthodox Medicine: A system in which medical doctors and other

healthcare professionals e.g Nurses, pharmacists, therapists, treat
symptoms and diseases using drugs, radiation or surgery. It is also called
allopathic medicine, biomedicine, conventional medicine, mainstream
and medicine, western medicine.

6. Older persons: Older persons within the context of this study are people
who are 60 years old and above which has further been disaggregated into
four different categories namely young old, old, old-old, and frail elderly.

In the various works reviewed, the concept of older persons has been
adopted to refer to adults/older persons around the age of 60 years and
above (Okumagba, 2011; Shofoyeke, 2014).

7. Health: Health, according to the World Health Organization is" a

state of complete Physical, Mental and Social Well-being and not merely
the absence of disease or infirmity" (WHO, 1948;, 2017). This definition
of Health will be a significant contribution to the area of Health as it has
explained health from the physiological, psychological and social
perspective, linking health with well-being. Although, this definition has
been a subject to criticisms since its appearance in 1948 with its primary
critics which describes it as unrealistic and leaving most persons
unhealthy since it has been difficult for anyone to attain complete
physical, mental and social well-being (Smith, 2008; Godlee, 2011)

HYPOTHESIS/PROPOSITION

CHAPTER THREE:

RESEARCH METHODOLOGY
Research Design: Mixed method approach will be used in the study. But will
involve quantitative and qualitative methods of data collection and analysis.
Thus the study will adopt triangulation strategy. The data for this study will be

14
obtained through the use of combination of quantitative data and qualitative
methods.

Representative quantitative data will be complemented with qualitative data

which will eventually produce a robust and rich representative data on health
care utilization model for the elderly.

The Study Area: This study will be carried out in the Alimosho Local
Government Area of Lagos State, Nigeria.

Lagos State was created in 1967 following the restructuring of Nigeria as a

Federating State.
Lagos State is the smallest state in Nigeria with a land mass of 3,577 square
kilometres.
Alimosho Local Government is the largest of all the Local Government Areas
in the State. Currently Alimosho Local Government has a population of about
1,456,783 residents (Lagos State Bureau of Statistic, 2022).

This study will focus on older persons and their perceived preference for
traditional medicines (Lagos State Bureau of Statistics, 2012)

The Study Population: The population for this study will be older persons (60
years and above) in Alimosho Local Government vis a vis their preference for
the use of traditional medicines in the Local Government as against Orthodox
medicine.
The population of the older persons in Alimosho Local Government Area
according to age disparity is as follows:
60 -64 years = 58,660
65 -74 years. = 24,370
75 -79 years = 8,806
80+ = 7,316
Total = 99,207

A multi-stage sampling procedure will be adopted to select respondents

included in the study comprising both males and females of age 60 years and
above.

15
Triangulation method will be used for data collection. Both primary and
secondary source of data will be utilized. Secondary source of data include the
review of relevant literature and available statistical data from previous
researches on the subject matter, while primary sources will be purely from
from the information gathered from the selected respondents on
the field from both qualitative and quantitative data. This will be administered
which will be later retrieved, coded and analysed.
The quantitative data collected will be analyzed using software package for
social science (SPSS).
Descriptive Statistics ( means, frequencies and percentages) will be used to
analyze the results. Additionally, twelve (12), Focused Group DIscussions will
be conducted, disaggregated by sex and age. Further twelve (12) in-depth and
three (3) Key Informant interviews will be conducted.

Validity and Reliability

Qualitative data will be grouped into themes and analyzed through content
analysis and ethnographic summaries. The findings from the qualitative data
will be used to compliment the results and findings of the quantitative data.
This will be done purposely to validate or debunk some claims from qualitative
data. It should be mentioned at this juncture that to achieve above, the question
will be structured in line with the various objectives of this study.

Sampling Technique: The study will involve the use of probability sampling
techniques for the quantitative aspect of the study and non-probability sampling
techniques for the qualitative aspect of the study.

Source of data: Data for this study will be in two categories namely: the
quantitative and qualitative data.

Sample Size: Six hundred (600) respondents are expected to be used for this
study in Alimosho Local Government combining both males and females
cutting across Christianity, Islam and African traditional religions.
Sample size is calculated using sample size determination formula:

n= z2p(1-p)
—------- —--(12)
d2

16
Where: n= estimated sample size
Z=is the standard normal value corresponding to the
desired level of confidence
d= error precision
p= people getting health care from traditional medicine
about (80%).
Therefore, adding the non respondent rate of 0.826%, the final size of 600
but 605 was used as sample size for the study.

Study instruments: the questionnaire was used as a major instrument for the
study and was divided into four sections:
Section A : Socio-demography
Section B : Knowledge of the respondent's on trad medicine
Section C:. Attitude of respondents towards traditional medicines.
The questions asked were both open and close ended. The open-ended
questions were used to obtain information on the source, benefits, adverse
effects and name of traditional medicines used. It also allowed participants to
give multiple responses to the open ended questions.

Methods of Data Analysis: The quantitative data gathered will first pass
through a preliminary stage before the proper Analysis of data. The preliminary
stage will involve sorting of research instruments, coding of data, entering into
SPSS software and cleaning up of the data.

Quantitative Analysis will be analyzed at univariate, bivariate and multivariate

levels which will comprise descriptive statistics, chi-square.

Method of Data Collection

Triangulation method will be used for data collection in this study.
Both Quantitative and Qualitative methods of data collection will be used in
this study.
For Quantitative Data Collection, structured questionaire will be used in this
study.
while Key Informant interview, Focussed Group Discussion, indepth interview
will be used for Qualitative Data Collection . This method will be used to
increase the credibility and validity of research findings.

17
Credibility refers to trustworthiness and how believable a study is while
validity refers to the extent to which a study accurately reflects or evaluates the
concept of idea being investigated

3.8: Ethical Consideration

There is no doubt that ethical consideration is one of the most important parts of
any social research. Hence, this study will follow all the ethical issues before,
during and after the research processes. Before embarking on the research
process, approval will be sought from the Alimosho Local Government before
embarking on study.
During the research process, participants’ consent will be sought on critical
aspects of the study. In some situations, questions will be read to the
participants to ensure adequate knowledge of the subject matters. No respondent
will be forced on any particular issue, hence, participants are expected to
participate voluntarily. Efforts will be made to avoid name mentioning, hence,
respect for individual participant privacy and anonymity will be given highest
considerations.

Field experience and Limitation of the Study

CHAPTER FOUR:

DATA ANALYSIS, INTERPRETATION AND PRESENTATION.

Socio-demographicCharacteristics of Respondents Results

CHAPTER FIVE:
DISCUSSIONS OF FINDINGS.
Alimosho Community is in Lagos State, Southwest, Nigeria. Alimosho is one
of the most populous rural communities in Lagos State known for its strict
adherence to traditional cultural practices and high rate of patronage of
traditional/herbal medicines. Inspite of social change which has swept all over
the face of, Nigeria - West Africa, the people of Alimosho still preserved many
of their cultural heritages including these of traditional medicines for healing
purposes. The situation among the Alimosho people confirmed the findings in
the literature as identified in other parts of the World (Andersen and Newman
1973; Rebhan 2008;Reibling and Wendt 2008).
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It should also be mentioned that findings in both the qualitative and quantitative
data analysed confirmed increase in the renew patronages of herbal medicine
among Alimosho residents. Many factors were identified to be responsible for
this. For instance, apart from very few countries in Africa,formal pension or
other social welfare schemes are virtually nonexistent and where they do exist,
only a very few of older population, about 5% benefits and covers a very small
fraction of the older population who worked in the formal sector of the
economy, hence majority have no access to social security systems and this has
created very serious problems for the older population, most especially those
that live in the rural areas of the developing countries. The situation discussed
above is a true reflection of the of what is happening among the older person in
Alimosho rural community of Lagos State, Nigeria in particular and the
experiencees of other older persons in other rural areas medicines in the Area.
These according to them include availability, accessibility, affordability and
traditional beliefs in the efficacy of traditional medicines.
However, majority of the participants also believe that if the Government can
develop modern health facilities in the rural areas, they were of the opinion that
majority will like to patronise modern medicine rather than patronising
traditional herbal medicines

CHAPTER SIX:
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS.

Conclusions and Recommendations

Studies on the health seeking behaviour of older persons is expected to
increase in the nearest future . This is a good omen for older persons on the one
hand and policy makers who work to improve the quality of life of the older
persons.
However, there is dearth of studies of the nexus of interactions between
herbalism and the health of older persons in the rural Alimosho, Lagos State ,
Nigeria. The study found that out various factors responsible for traditional
medicines patronages in the rural areas, Southwest, Nigeria despite the increase
in modern health facilities in both rural and urban settings in Nigeria.
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 The study found out that despite the dramatic advances of conventional
medicines, it is clearthat traditional medicines continue to possess a high level
of significance among older persons in rural areas of Southwest, Nigeria

The study recommends that the Government should take a bold step to regulate
the practice of traditional medicines and establish a working relationship or
collaborations between traditional and orthodox medical practitioners in
Nigeria.

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