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Perception and attitude of religious leaders and outpatients in Dhaka, Bangladesh with regard to Ayurvedic medicine

Yoshitoku Yoshida

Faculty of Nursing, Shubun University, Japan

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

Yasuko Yoshida

Graduate School of Pharmaceutical Sciences, Nagoya City University, Japan

Md. Abdul Alim

Institute of Public Health Nutrition, Bangladesh

Zakia Alam

Institute of Public Health Nutrition, Bangladesh

Mohammad Asaduzzaman

National Tuberculosis Control Program, Directorate General of Health Services, Leprosy Hospital Compound, Bangladesh

Manikdrs Shahabuddin

National Tuberculosis Control Program, Directorate General of Health Services, Leprosy Hospital Compound, Bangladesh

DOI: 10.15761/BRCP.1000120

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Abstract

Objectives: Because of limited medical and financial resources, the use of complementary and alternative medicine (CAM) should be markedly expanded in Bangladesh. From the viewpoint of increasing the use of Ayurvedic medicine (AM) including herbal medicine (HM) more vigorously, new and important recommendations need to be obtained through data comparison among Muslim religious leaders (MRLs), AM outpatients (AMOPTs), and orthodox medicine outpatients (OMOPTs). Therefore, the aim of this study was to confirm the perception and attitude of MRLs, AMOPTs, and OMOPTs toward AM in Dhaka, Bangladesh.

Method: This study was conducted from February to June 2015 by trained staff members using a structured questionnaire. The interview respondents were 150 MRLs, 202 AMOPTs, and 150 OMOPTs in Dhaka, Bangladesh.

Results: More than 85% AMOPTs and MRLs had a person who helped him/her to use AM; however, only 10.3% OMOPTs had such a person. OMOPTs were skeptical but had no one to help them use AM and suggests that OMOPTs were not familiar with using AM. In terms of attitudes, OMOPTs harbored more skepticism than the other two groups.

Conclusions: If OMOPTs had more chances of becoming familiar with AM through someone helping them with its use, then they would use AM more. In addition, to increase the use of AM, appropriate information on its efficacy and safety should be provided to the general public to avoid skepticism.

Key words

ayurvedic medicine, perception, Bangladesh, religious leader, outpatient

Introduction

To enact the concept of the Declaration of Alma-Ata in 1978 [1] the World Health Organization (WHO) prepared the WHO Traditional Medicine Strategy 2014-2023 [2]. The main purpose of this strategy is to help member states promote the safe and effective use of traditional medicine (TM).

In Japan, herbal medicine (HM) is used as Kampo, which is covered by universal health insurance [3-5]. Furthermore, to provide evidence-based medicine to patients, a lot of rigorous studies have been conducted on the efficacy and safety of Kampo [6-13].

In Bangladesh, economic growth has remarkably progressed; however, the central government is struggling with difficulties related to public health issues [14-21]. In terms of the resource limitations of healthcare and economical activities, the use of complementary and alternative medicine (CAM) needs to be considerably increased in Bangladesh.

In Bangladesh, a national policy on TM and CAM was issued in 1995. However, national laws and regulations are currently in the development stage. Although a national program was introduced in 1998, national research institutes on TM, CAM, or Ayurvedic medicine (AM) including HM have not yet been established. Whereas HMs are regulated as prescription and over-the-counter drugs, national herbal monographs have not yet been developed. The Drug Administration is in charge of ensuring the implementation of pharmacopeias and monographs, good manufacturing practice (GMP) rules for conventional pharmaceuticals, and special GMP rules; however, no detailed information about specific mechanisms is available. A registration system for HMs exists; however, the number of registered products is unavailable. A post-marketing surveillance system is currently under development. The Ministry of Health and Family Welfare of Bangladesh adopts various countermeasures to promote the health and welfare of the country.

Therefore, in 2011, a study on the perceptions of Muslim religious leaders (MRLs) and citizens in Bangladesh regarding AM was performed by a team involving two of the current authors [22,23]. We chose not only citizens but also MRLs as respondents because MRLs influence the lives of citizens, including the use of AM. The results showed that MRLs had an adequate perception, satisfaction, and a very positive attitude toward HM and regarded the mass media as having a significant contribution toward its promotion. However, the citizens believed that scientifically sound information on AM should be promptly collected to eliminate the skepticism of younger citizens in Dhaka. Because of limited medical and financial resources, the use of CAM needs to markedly increase in Bangladesh. The latter studies were conducted in Bangladesh in 2011; however, at that time, we did not collect data from AM outpatients (AMOPTs) or orthodox medicine outpatients (OMOPTs). From the viewpoint of further increasing the use of AM, other important and new recommendations might be obtained through data comparison among MRLs, AMOPTs, and OMOPTs.

Therefore, the aim of this study was to confirm the perception and attitude of MRLs, AMOPTs, and OMOPTs to AM in Dhaka, Bangladesh.

Materials and methods

This study was conducted in Dhaka, Bangladesh from February to June 2015 by face-to-face interviews with trained staff members using a structured questionnaire. The four data-collecting staff members had been trained in collecting data from the respondents. Their interviewing skills were also assessed prior to conducting the interviews.

The interview respondents included 150 MRLs, 202 AMOPTs, and 150 OMOPTs who were randomly selected and recruited by the trained staff members of the Bangladeshi research team. In terms of recruit of AMOPTs and OMOPTs, the trained staff members of the Bangladeshi research team visited a hospital or an office of practitioner and randomly picked up 202 AMOPTs, and 150 OMOPTs who visited that place. There were no exclusion criteria in this study. The subjects were informed that they were free not to respond to any question that they were not comfortable answering. Their anonymity was preserved. Verbal informed consent was obtained from every participant prior to the interview.

The questionnaire was translated from English into Bengali and was modified for the respondents’ understanding before data collection in the field. It was then back-translated to English. The respondents responded to situations and perceptions regarding AM use and satisfaction from AM use. For questions on attitudes toward AM use, a 5-point Likert scale ranging from 1 = “Strongly disagree” to 5 = “Strongly agree” was applied.

Raw data were sent to Nagoya University and analyzed using SPSS version 2.0. χ2-test and Kruskal-Wallis test were applied.

Prior to data collection, the study protocol was approved on October 23, 2014 by the Ethics Committee of the Graduate School of Medicine, Nagoya University (approval number: 2014-0208).

Results

Table 1 shows the demographics of the respondents. We obtained responses from 150 MRLs, 202 AMOPTs, and 150 OMOPTs. In terms of age, 52.7% MRLs were 35-54 years old, 48.5% AMOPs were 15-54 years old, and 54.7% OMOPTs were 35-54 years old. With regard to gender, 95.3% MRLs, 58.6% AMOPTs, and 78.0% OMOPTs were male. In terms of marital status, 80.0% MRLs, 75.1% AMOPTs, and 78.0% OMOPTs were married. With regard to the amount of use of AM per year, 47.9% MRLs marked 5 to 6 times, 49.5% AMOPTs marked 3 to 4 times, and 45.0% OMOPTs marked 0 times. In terms of the amount of use of OM per year, 38.7% MRLs marked 5 to 6 times, 49.2% AMOPTs marked 1 to 2 times, and 57.9% OMOPTs marked 5 to 6 times. These five items had statistically significant differences. Thus, fraction of young respondents was greater for AMOPTs relative to MRLs and OMOPTs.  It was noted that the frequency of the use of AM was higher for MRLs than AMOPTs which was in turn higher than OMOPTs.

Table 1. Demographic data of respondents in Dhaka, Bangladesh

 

Sex

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of Orthodox medicine

Total

Testa

 

 

n

%

n

%

n

%

n

%

 

 

Age

15-34

52

34.7%

98

48.5%

40

26.7%

190

37.8%

**

35-54

79

52.7%

73

36.1%

82

54.7%

234

46.6%

55 or more

19

12.7%

31

15.3%

28

18.7%

78

15.5%

Total

150

100.0%

202

100.0%

150

100.0%

502

100.0%

 

 

Gender

Male

143

95.3%

116

58.6%

117

78.0%

376

78.0%

**

Female

7

4.7%

82

41.4%

33

22.0%

122

22.0%

Total

150

100.0%

198

100.0%

150

100.0%

498

100.0%

 

 

Marital status

Married

120

80.0%

136

75.1%

111

74.0%

367

76.3%

**

Unmarried

30

20.0%

38

21.0%

25

16.7%

93

19.3%

Widow

0

0.0%

7

3.9%

11

7.3%

18

3.7%

Divorced/separated

0

0.0%

0

0.0%

3

2.0%

3

0.6%

Total

150

100.0%

181

100.0%

150

100.0%

481

100.0%

 

 

 

 

 

Education

Dakhil

6

4.0%

 

 

 

 

 

 

-

Alim

30

20.1%

 

 

 

 

 

 

Fajil

14

9.4%

 

 

 

 

 

 

Kamil

99

66.4%

 

 

 

 

 

 

Total

149

100.0%

 

 

 

 

 

 

 

No education

 

 

52

29.5%

20

13.4%

72

22.2%

**

Primary

 

 

41

23.3%

26

17.4%

67

20.6%

6-10

 

 

28

15.9%

21

14.1%

49

15.1%

11 and more

 

 

55

31.3%

82

55.0%

137

42.2%

Total

 

 

176

100.0%

149

100.0%

325

100.0%

 

 

 

 

 

 

 

Occupation

Madrasa teacher

82

55.8%

 

 

 

 

 

 

-

Imam

33

22.4%

 

 

 

 

 

 

Muazzin

4

2.7%

 

 

 

 

 

 

Others

28

19.0%

 

 

 

 

 

 

Total

147

100.0%

 

 

 

 

 

 

 

Service

 

 

43

24.0%

51

34.5%

94

28.7%

**

Business

 

 

55

30.7%

42

28.4%

97

29.7%

Housewife

 

 

49

27.4%

24

16.2%

73

22.3%

Jobless

 

 

4

2.2%

13

8.8%

17

5.2%

Others

 

 

28

15.6%

18

12.2%

46

14.1%

Total

 

 

179

100.0%

148

100.0%

327

100.0%

Monthly income

 (in Takab)

<10000

51

34.7%

 

 

 

 

 

 

-

10000-20000

84

57.1%

 

 

 

 

 

 

>20000

12

8.2%

 

 

 

 

 

 

Total

147

100.0%

 

 

 

 

 

 

 

<7000

 

 

55

45.1%

60

42.6%

115

43.7%

n.s.

7000-15000

 

 

50

41.0%

67

47.5%

117

44.5%

>15000

 

 

17

13.9%

14

9.9%

31

11.8%

Total

 

 

122

100.0%

141

100.0%

263

100.0%

 

 

Religion

Islam

150

100.0%

 

 

 

 

 

 

 

Islam

 

 

181

95.3%

130

88.4%

311

92.3%

*

Hindu

 

 

8

4.2%

14

9.5%

22

6.5%

Buddhism

 

 

0

0.0%

2

1.4%

2

0.6%

Christian

 

 

0

0.0%

1

0.7%

1

0.3%

Others

 

 

1

0.5%

0

0.0%

1

0.3%

Total

 

 

190

100.0%

147

100.0%

337

100.0%

 

 

No of use of Ayurvedic medicine

a year

0

15

10.6%

1

0.5%

67

45.0%

83

16.8%

**

1-2

27

19.0%

45

22.3%

51

34.2%

123

24.9%

3-4

26

18.3%

100

49.5%

23

15.4%

149

30.2%

5-6

68

47.9%

46

22.8%

8

5.4%

122

24.7%

6 or more

6

4.2%

10

5.0%

0

0.0%

16

3.2%

Total

142

100.0%

202

100.0%

149

100.0%

493

100.0%

 

 

No of use of Orthodox medicine

a year

0

2

1.7%

5

2.6%

3

2.1%

10

2.2%

**

1-2

17

14.3%

94

49.2%

4

2.8%

115

25.3%

3-4

42

35.3%

55

28.8%

39

26.9%

136

29.9%

5-6

46

38.7%

29

15.2%

84

57.9%

159

34.9%

6 or more

12

10.1%

8

4.2%

15

10.3%

35

7.7%

Total

119

100.0%

191

100.0%

145

100.0%

455

100.0%

 

 

Mean

10‰

90‰

Mean

10‰

90‰

Mean

10‰

90‰

 

Expenditure of Ayurvedic medicine

a yearb

1026.7

300

2000

1152.6

200

2550

376.4

000

1230

 

Expenditure of Orthodox medicine

a yearb

3575.8

560

7000

2748.1

500

5000

3707.3

560

5000

 

aKruskal-Wallis test for Age, Monthly income, No. of use of Ayurvedic medicine, and No. of use of Orthodox medicine

χ2-test for gender, Marital status, Education, Occupation, Religion

b1USD =70 Taka

**P < 0.01, *P < 0.05

With regard to education, 31.3% AMOPTs and 55.0% OMOPTs had 11 or more years of education. In terms of occupation, 30.7% AMOPTs worked in business, and 34.5% OMOPTs worked in service. These two items had statistically significant differences. With regard to monthly income, 45.1% AMOPTs earned 7000 Taka or less, and 41.0% earned 7000-150000 Taka. On the other hand, 47.5% OMOPTs earned 7000-150000 Taka, and 42.6% earned 7000 Taka or less. There was no statistical significance, but there seemed to be some trend that higher income for OMOPTs relative to AMOPTs. In terms of religion, 95.3% AMOPTs were Muslim, and 4.2% were Hindu. On the other hand, 88.4% OMOPTs were Muslim, and 9.5% were Hindu. There was a statistically significant difference.

Table 2 shows the perception toward AM use in Dhaka, Bangladesh. In terms of the mode of the effect of AM, 62.1% MRLs believed that it was for the prevention of disease. On the other hand, 37.9% AMOPTs believed that it was for the treatment of disease, and 37.4% believed that it was for health promotion. Furthermore, 58.5% OMOPTs believed that it was for health promotion. Moreover, 64.8% MRLs believed that AM worked via disease eradication, and 26.2% believed that AM worked through relaxation. On the other hand, 72.8% AMOPTs believed that AM worked via disease eradication, and 25.2% believed that AM improved the body’s defenses. In addition, 30.9% OMOPTs believed that AM worked through improving the body’s defenses, and 38.3% believed that AM worked via disease eradication. There were statistically significant differences. Regarding the effectiveness of AM in males and females, 95.9% MRLs, 97.4% AMOPTs, and 96.6% OMOPTs believed that AM was effective in both males and females. There was a statistically significant difference. Thus, these results demonstrate a marked difference in perception of significance of AM along the three groups.

Table 2. Perception on Ayurvedic medicine (AM) use in Dhaka, Bangladesh

 

Respondents

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

Test

   

n

%

n

%

n

%

n

%

 

AM including HM is effective for -

 

Only male

2

1.4%

2

1.0%

2

1.4%

6

1.2%

n.s.

Only female

4

2.7%

3

1.5%

3

2.0%

10

2.1%

 

Both male and female

140

95.9%

189

97.4%

142

96.6%

471

96.7%

 

Total

146

100.0%

194

100.0%

147

100.0%

487

100.0%

 

Mode of effect of AM including HM

 

Prevention of disease

90

62.1%

45

23.1%

39

26.5%

174

35.7%

**

Treatment of diseases

31

21.4%

73

37.4%

20

13.6%

124

25.5%

 

Promotion of health

18

12.4%

74

37.9%

86

58.5%

178

36.6%

 

Others

6

4.1%

3

1.5%

2

1.4%

11

2.3%

 

Total

145

100.0%

195

100.0%

147

100.0%

487

100.0%

 

How AM including HM works?

 

Eradicate disease

94

64.8%

147

72.8%

46

30.9%

287

57.9%

**

Improve body defense

7

4.8%

51

25.2%

57

38.3%

115

23.2%

 

Keep relax

38

26.2%

1

0.5%

37

24.8%

76

15.3%

 

Remove bad effect of Orthodox medicine

1

0.7%

3

1.5%

3

2.0%

7

1.4%

 

Cures symptoms only

5

3.4%

0

0.0%

6

4.0%

11

2.2%

 

Total

145

100.0%

202

100.0%

149

100.0%

496

100.0%

 

χ2-test was used

**p < 0.01

With regard to satisfaction of AM use, as shown in Table 3, 89.9% MRLs, 99.5% AMOPTs, and 60.0% OMOPTs reported benefit from AM. In contrast, 4.1% MRLs, 62.2% AMOPTs, and 0.0% OMOPTs reported harm from AM. Furthermore, 4.1% MRLs, 36.7% AMOPTs, and 8.9% OMOPTs were very satisfied with AM, and 93.2% MRLs, 62.7% AMOPTs, and 88.4% OMOPTs were satisfied with AM. Moreover, 93.9% MRLs, 99.0% AMOPTs, and 57.5% OMOPTs said that they would recommend AM to others. Of note, 88.6% MRLs, 85.6% AMOPTs, and 10.3% OMOPTs had a person who helped them use AM, whereas, 70.9% MRLs, 100.0% AMOPTs, and 78.5% OMOPTs believed that the government should take more initiative in promoting AM. Furthermore, 87.4% MRLs, 98.9% AMOPTs, and 6.4% OMOPTs believed that if the treatment cost was the same, they would choose AM. These differences were statistically significant. Overall, this section represents greater degrees of satisfaction of the MRLs and AMOPTs compared to OMOPTs.

Table 3. Satisfaction on Ayurvedic medicine (AM) use in Dhaka, Bangladesh

 

Respondents

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

Test

   

n

%

n

%

n

%

n

%

 

Did you get benefit from AM?

 

Yes

133

89.9%

200

99.5%

90

60.0%

423

84.8%

**

No

15

10.1%

1

0.5%

60

40.0%

76

15.2%

 

Total

148

100.0%

201

100.0%

150

100.0%

499

100.0%

 

Did you get harm from AM?

 

Yes

6

4.1%

139

62.2%

0

0.0%

145

29.2%

**

No

142

95.9%

62

30.8%

148

100.0%

352

70.8%

 

Total

148

100.0%

201

100.0%

148

100.0%

497

100.0%

 

Were you satisfied with AM?

 

Very satisfied

6

4.1%

65

36.7%

10

8.9%

81

18.6%

**

Satisfied

137

93.2%

111

62.7%

99

88.4%

347

79.6%

 

Dissatisfied

4

2.7%

1

0.6%

3

2.7%

8

1.8%

 

Total

147

100.0%

177

100.0%

112

100.0%

436

100.0%

 

Did you recommend AM to others?

 

Yes

138

93.9%

198

99.0%

84

57.5%

420

85.2%

**

No

9

6.1%

2

1.0%

62

42.5%

73

14.8%

 

Total

147

100.0%

200

100.0%

146

100.0%

493

100.0%

 

Does anybody help you using AM?

 

Yes

124

88.6%

161

85.6%

15

10.3%

300

63.3%

**

No

16

11.4%

27

14.4%

131

89.7%

174

36.7%

 

Total

140

100.0%

188

100.0%

146

100.0%

474

100.0%

 

Government should take more initiatives to promote AM

 

Yes

105

70.9%

196

100.0%

117

78.5%

418

84.8%

**

No

1

0.7%

0

0.0%

8

5.4%

9

1.8%

 

Existing initiatives are enough

42

28.4%

0

0.0%

24

16.1%

66

13.4%

 

Total

148

100.0%

196

100.0%

149

100.0%

493

100.0%

 

If treatment cost is same, which will you choose?

AM

125

87.4%

180

98.9%

9

6.4%

314

67.5.%

**

Orthodox medicine

18

12.6%

2

1.1%

131

93.6%

151

32.5%

 

Total

143

100.0%

182

100.0%

140

100.0%

465

100.0%

 

χ2-test was used

**p < 0.01

Regarding the attitudes toward AM, as shown in Table 4, 73.5% MRLs agreed, and 17.7% had not decided whether the AM provider gave good information on maintaining a healthy lifestyle. Furthermore, 70.1% AMOPTs strongly agreed, and 27.9% agreed that the AM provider gave good information on maintaining a healthy lifestyle. Moreover, 56.0% OMOPTs had not decided, and 42.7% agreed that the AM provider gave good information on maintaining a healthy lifestyle. In addition, 74.5% MRLs agreed that HM had fewer side effects. Moreover, 71.7% AMOPTs strongly agreed that HM had fewer side effects. Regarding side effects, 69.3% OMOPTs agreed that HM had fewer side effects. Furthermore, 77.2% MRLs agreed, and 13.4% had not decided whether AM involved natural plant formulas, which were healthier than taking drugs given by medical doctors. Moreover, 71.7% AMOPTs strongly agreed, and 26.3% agreed that AM involved natural plant formulas healthier than such drugs. On the other hand, 88.0% OMOPTs agreed on such plant formulas healthier than such drugs. In addition, 80.5% MRLs agreed, and 10.7% strongly agreed that people would be more likely to use AM if there were more AM clinics. Furthermore, 77.8% AMOPTs strongly agreed, and 20.2% agreed that people would be more likely to use AM if there were more AM clinics. On the other hand, 84.7% OMOPTs agreed, and 13.3% had not decided whether people would be more likely to use AM if there were more AM clinics. Moreover, 79.01% MRLs agreed, and 10.1% strongly agreed that AM built up the body’s own defenses. Furthermore, 76.6% AMOPTs strongly agreed, and 21.3% agreed that AM built up the body’s own defenses. On the other hand, 66.7% OMOPTs agreed, and 28.7% had not decided whether AM built up the body’s own defenses. These responses consistently reflected the positive attitudes of AMOPTs toward AM compared to MRLs and OMOPTs.  Next we addressed the questions regarding the potential factors influencing such attitudes. 82.6% MRLs agreed, and 11.4% strongly agreed that the more knowledge a person had on AM, the more likely he/she would use it. Furthermore, 70.7% AMOPTs strongly agreed, and 26.8% agreed on the potential effect of the knowledge. On the other hand, 72.7% OMOPTs agreed, and 26.0% had not decided about the potential effect of the knowledge. Moreover, 73.2% MRLs agreed, and 16.1% strongly agreed that parents could influence youths to use AM by exposing them to it. Furthermore, 65.3% AMOPTs strongly agreed, and 30.1% agreed that parents could influence youths to use AM by exposing them to it. On the other hand, 82.7% OMOPTs agreed, and 17.3% had not decided whether parents could influence youths to use AM by exposing them to it. In addition, 73.8% MRLs agreed, and 15.4% strongly agreed that people could be influenced to use AM if friends were using it. Furthermore, 65.3% AMOPTs strongly agreed, and 27.0% agreed that people could be influenced to use AM if friends were using it. On the other hand, 78.0% OMOPTs agreed, and 20.0% had not decided about the potential influence from friends. Moreover, 72.5% MRLs agreed, and 12.8% strongly agreed that teachers could influence youths to use AM by exposing them to it. Furthermore, 56.6% AMOPTs strongly agreed, and 32.7% agreed on the teachers’ influence about the exposure. On the other hand, 73.2% OMOPTs agreed, and 24.2% had not decided whether teachers could have such an influence. In addition, 73.6% MRLs agreed, and 14.9% strongly agreed that people who believed in the physical, mental, and spiritual aspects of health were more likely to use AM. Furthermore, 46.1% AMOPTs agreed, and 32.6% had not decided whether people who believed in them were more likely to use AM. On the other hand, 54.7% OMOPTs had not decided, and 38.7% agreed that people who believed in them were more likely to use AM. Moreover, 73.6% MRLs agreed, and 12.2% strongly agreed that those who feared the discomfort of treatment from medical doctors were more likely to use AM. Furthermore, 57.1% AMOPTs had not decided, and 14.6% agreed that those with such a fear were more likely to use AM. On the other hand, 38.0% OMOPTs had not decided, and 35.3% agreed that those with such a fear were more likely to use AM. In addition, 77.0% MRLs agreed, and 13.5% strongly agreed that AM was not harmful. Furthermore, 50.0% AMOPTs had not decided, and 14.6% agreed that AM was not harmful. On the other hand, 52.0% OMOPTs agreed, and 44.7% had not decided whether AM was not harmful. Moreover, 77.4% MRLs agreed, and 11.6% strongly agreed that people were motivated to use AM mostly by television, radio, and the mass media. Furthermore, 71.2% AMOPTs strongly agreed, and 24.7% agreed with such an effect of the media. On the other hand, 90.7% OMOPTs agreed with such an effect of the media. These differences were statistically significant.

Table 4. Attitudes of the citizens on Ayurvedic medicine (AM) in Dhaka, Bangladesh

 

Respondents

 

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

test

AM provider gives good information on maintaining a healthy lifestyle

 

Strongly disagree

2

1.4%

0

0.0%

0

0.0%

2

0.4%

**

Disagree

2

1.4%

0

1.0%

2

1.3%

6

1.2%

 

Haven't decided

26

17.7%

2

1.0%

84

56.0%

112

22.7%

 

Agree

108

73.5%

55

27.9%

64

42.7%

227

46.0%

 

Strongly agree

9

6.1%

138

70.1%

0

0.0%

147

29.8%

 

Total

147

100.0%

197

100.0%

150

100.0%

494

100.0%

 

Herbal medicine has less side effects

 

Strongly disagree

1

0.7%

0

0.0%

1

0.7%

2

0.4%

**

Disagree

2

1.3%

0

0.0%

1

0.7%

3

0.6%

 

Haven't decided

23

15.4%

2

1.0%

42

28.0%

67

13.5%

 

Agree

111

74.5%

54

27.3%

104

69.3%

269

54.1%

 

Strongly agree

12

8.1%

142

71.7%

2

1.3%

156

31.4%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

AM involves natural plant formulas which are healthier than taking drugs given by the medical doctors

 

Strongly disagree

0

0.0%

0

0.0%

0

0.0%

0

0.0%

**

Disagree

2

1.3%

0

0.0%

1

0.7%

3

0.6%

 

Haven't decided

20

13.4%

4

2.0%

12

8.0%

36

7.2%

 

Agree

115

77.2%

52

26.3%

132

88.0%

299

60.2%

 

Strongly agree

12

8.1%

142

71.7%

5

3.3%

159

32.0%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

People would be more likely to use AM if there were more AM clinics

 

Strongly disagree

1

0.7%

0

0.0%

1

0.7%

2

0.4%

**

Disagree

2

1.3%

1

0.5%

2

1.3%

5

1.0%

 

Haven't decided

10

6.7%

3

1.5%

20

13.3%

33

6.6%

 

Agree

120

80.5%

40

20.2%

127

84.7%

287

57.7%

 

Strongly agree

16

10.7%

154

77.8%

0

0.0%

170

34.2%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

AM build up the body’s own defenses

Strongly disagree

0

0.0%

0

0.0%

2

1.3%

2

0.4%

**

Disagree

3

2.0%

0

0.0%

2

1.3%

5

1.0%

 

Haven't decided

13

8.8%

4

2.0%

43

28.7%

60

12.1%

 

Agree

117

79.1%

42

21.3%

100

66.7%

259

52.3%

 

Strongly agree

15

10.1%

151

76.6%

3

2.0%

169

34.1%

 

Total

148

100.0%

197

100.0%

150

100.0%

495

100.0%

 

The more knowledge a person has on AM, the more likely he/she use it

 

Strongly disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

**

Disagree

1

0.7%

1

0.5%

1

0.7%

3

0.6%

 

Haven't decided

7

4.7%

4

2.0%

39

26.0%

50

10.1%

 

Agree

123

82.6%

53

26.8%

109

72.7%

285

57.3%

 

Strongly agree

17

11.4%

140

70.7%

1

0.7%

158

31.8%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

Parent(s) can influence youth’s AM use by exposing them to it

 

Strongly disagree

2

1.3%

0

0.0%

0

0.0%

2

0.4%

**

Disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

 

Haven't decided

13

8.7%

5

2.6%

26

17.3%

44

8.9%

 

Agree

109

73.2%

59

30.1%

124

82.7%

292

59.0%

 

Strongly agree

24

16.1%

132

67.3%

0

0.0%

156

31.5%

 

Total

149

100.0%

196

100.0%

150

100.0%

495

100.0%

 

People can be influenced to use AM if friends are using it

 

Strongly disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

**

Disagree

4

2.7%

0

0.0%

3

2.0%

7

1.4%

 

Haven't decided

11

7.4%

15

7.7%

30

20.0%

56

11.3%

 

Agree

110

73.8%

53

27.0%

117

78.0%

280

56.6%

 

Strongly agree

23

15.4%

128

65.3%

0

0.0%

151

30.5%

 

Total

149

100.0%

196

100.0%

150

100.0%

495

100.0%

 

Teacher can influence youth’s AM use by exposing them to it

 

Strongly disagree

0

0.0%

0

0.0%

1

0.7%

1

0.2%

**

Disagree

4

2.7%

0

0.0%

2

1.3%

6

1.2%

 

Haven't decided

18

12.1%

21

10.7%

36

24.2%

75

15.2%

 

Agree

108

72.5%

64

32.7%

109

73.2%

281

56.9%

 

Strongly agree

19

12.8%

111

56.6%

1

0.7%

131

26.5%

 

Total

149

100.0%

196

100.0%

149

100.0%

494

100.0%

 

People who believe in the physical, mental and spiritual aspects of health are more likely to use AM

Strongly disagree

4

2.7%

0

0.0%

1

0.7%

5

1.0%

**

Disagree

1

0.7%

1

0.5%

5

3.3%

7

1.4%

 

Haven't decided

12

8.1%

63

32.6%

82

54.7%

157

32.0%

 

Agree

109

73.6%

89

46.1%

58

38.7%

256

52.1%

 

Strongly agree

22

14.9%

40

20.7%

4

2.7%

66

13.4%

 

Total

148

100.0%

193

100.0%

150

100.0%

491

100.0%

 

Those who fear the discomfort of treatment from medical doctors are more likely to use AM

 

Strongly disagree

6

4.1%

11

5.6%

4

2.7%

21

4.2%

**

Disagree

2

1.4%

25

12.6%

30

20.0%

57

11.5%

 

Haven't decided

13

8.8%

113

57.1%

57

38.0%

183

36.9%

 

Agree

109

73.6%

29

14.6%

53

35.3%

191

38.5%

 

Strongly agree

18

12.2%

20

10.1%

6

4.0%

44

8.9%

 

Total

148

100.0%

198

100.0%

150

100.0%

496

100.0%

 

 

 

 

 

 

AM are not harmful

 

Strongly disagree

0

0.0%

18

9.2%

0

0.0%

18

3.6%

**

Disagree

6

4.1%

28

14.3%

4

2.7%

38

7.7%

 

Haven't decided

8

5.4%

98

50.0%

67

44.7%

173

35.0%

 

Agree

114

77.0%

39

19.9%

78

52.0%

231

46.8%

 

Strongly agree

20

13.5%

13

6.6%

1

0.7%

34

6.9%

 

Total

148

100.0%

196

100.0%

150

100.0%

494

100.0%

 

People are mostly motivated to use AM by television, radio and mass media

Strongly disagree

6

4.1%

0

0.0%

0

0.0%

6

1.2%

**

Disagree

2

1.4%

1

0.5%

0

0.0%

3

0.6%

 

Haven't decided

8

5.5%

7

3.5%

9

6.0%

24

4.9%

 

Agree

113

77.4%

49

24.7%

136

90.7%

298

60.3%

 

Strongly agree

17

11.6%

141

71.2%

5

3.3%

163

33.0%

 

 

Total

146

100.0%

198

100.0%

150

100.0%

494

100.0%

 

χ2-test was used

**p < 0.01, *p < 0.05

Discussion

The results of this study show that the cost of AM seems to be cheaper than the cost of OM. However, with regard to monthly income, there were no statistically significant differences among AMOPTs and OMOPTs. In addition, approximately 50% AMOPTs were 15-34 years old; on the other hand, the majority of OMOPTs were 35-54 years old. In terms of education, OMOPTs had a higher level of education compared to AMOPTs. From the viewpoint of the perception of AM use in Dhaka, the majority of MRLs believed that AM’s mode of effect was prevention of disease. More than one third of AMOPTs believed that it was for disease treatment and health promotion. On the other hand, the majority of OMOPTs believed that AM was for health promotion. Furthermore, whereas the majority of MRLs and AMOPTs believed that AM works via disease eradication, 38.0% AMOPTs believed that AM works through improving the body’s defenses, followed by disease eradication (30.9%). This demonstrates that there was a large gap in the perception of AM among OMOPTs and the other two groups. The purpose of this study was not only to confirm differences among MRLs, AMOPTs, and OMOPTs but also to confirm that the differences in demographic characteristics were large; this is one of the limitations of this study. However, we think that the difference in the demographic characteristics between the three groups has a meaning.

The results of this study also showed that more than 50% AMOPTs perceived harm from AM; however, the scores regarding satisfaction were higher than for MRLs and OMOPTs. Moreover, 98.9% and 87.4% AMOPTs and MRLs, respectively, would have used AM as the first choice if the cost of treatment was the same. This means that AMOPTs and MRLs trusted the efficacy of AM more. More than 85% AMOPTs and MRLs had a person who helped him/her use AM; however, only 10.3% OMOPTs had such a person. This suggested that OMOPTs had more skepticism through not having a person who helped in using AM and were not familiar with using AM. If they had more chance to be familiar with the AM through the help of another person, then, they might use it more.

With regard to attitudes, the results of this study also showed that AMOPTs were the most positive toward AM and that MRLs were also positive; however, OMOPTs were not so positive. In addition, in terms of the influence of parents, friends, and teachers, as a whole, more than 90% respondents believed that their parents influenced the use of AM, followed by friends (87.1%) and teachers (83.4%). This also suggests that a person who supports the use of AM is very important in increasing its use. OMOPTs harbored more skepticism than the other two groups. Therefore, to increase the use of AM, appropriate information on its efficacy and safety should be delivered to the general public to avoid skepticism.

In this research, we focused on the difference among MRLs, AMOPTs, and OMOPTs to enhance the usage of AM more. On the other hand, in 2010 we conducted the similar research to confirm the basic perceptions of AM by citizens in Dhaka [23]. The research demonstrated that in terms of effectiveness of AM, the younger generation in Dhaka seemed to be more skeptical to AM than the elder generation in Dhaka, even though the younger generation were more satisfied with AM than the elder generation. Based on the results, with viewpoint of enhancement of usage of AM in Dhaka, we recommended that scientifically sound information on AM should be collected rigorously and brought to the citizens vigorously to remove the skeptical feeling of AM from younger citizen in Dhaka.

In addition, we conducted a study in Japan, and it demonstrated that there was a large gap in the perception of medical terms between citizens and healthcare workers [24-26]. The gaps between the basic recognition of the medical terms by laypeople and that estimated by medical doctors suggest that the possibility that patients cannot recognize much more difficult terms should be considered [24]. In addition, compared with medical doctors, pharmacists tend to overestimate patients’ recognition level of medical terms [25]. Furthermore, the level of medical term recognition by patients was much higher when estimated by nurses than when estimated by medical doctors. As members of team care, pharmacists and nurses must consider that patients find technical medical terms to be more difficult than anticipated and that patients are aware of these terms only to a certain extent while receiving healthcare information, such as drug information [26]. Through these results in Japan, we believe that it is critical to address these perception gaps to enhance medical care, which includes AM, in Bangladesh as well.

This study was conducted in Dhaka; however, this type of study should be expanded to other cities in Bangladesh and other countries in Asia with the objective of increasing the use of AM.

We hope that this study will help increase the use of AM, including HM, in not only Bangladesh but also worldwide.

Acknowledgments

This study was partially supported by the Research Foundation for Oriental Medicine.

Conflicts of interest

The authors declare that they have no conflicts of interest.

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Editorial Information

Editor-in-Chief

Kazuhisa Nishizawa
Teikyo University

Article Type

Research Article

Publication history

Received date: October 19, 2016
Accepted date: October 25, 2016
Published date: October 31, 2016

Copyright

© Yoshida Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Yoshida Y, Yoshida Y, Alim MA, Alam Z, Asaduzzaman M, et al. (2016) Perception and attitude of religious leaders and outpatients in Dhaka, Bangladesh with regard to Ayurvedic medicine. Biomed Res Clin Prac 1: DOI: 10.15761/BRCP.1000120.

Corresponding author

Yoshitoku Yoshida

Faculty of Nursing, Shubun University, 6 Nikko-cho, Ichinomiya City, Aichi Prefecture, 491-0938, Japan, Tel and Fax: +81-586-45-2101;

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

Table 1. Demographic data of respondents in Dhaka, Bangladesh

 

Sex

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of Orthodox medicine

Total

Testa

 

 

n

%

n

%

n

%

n

%

 

 

Age

15-34

52

34.7%

98

48.5%

40

26.7%

190

37.8%

**

35-54

79

52.7%

73

36.1%

82

54.7%

234

46.6%

55 or more

19

12.7%

31

15.3%

28

18.7%

78

15.5%

Total

150

100.0%

202

100.0%

150

100.0%

502

100.0%

 

 

Gender

Male

143

95.3%

116

58.6%

117

78.0%

376

78.0%

**

Female

7

4.7%

82

41.4%

33

22.0%

122

22.0%

Total

150

100.0%

198

100.0%

150

100.0%

498

100.0%

 

 

Marital status

Married

120

80.0%

136

75.1%

111

74.0%

367

76.3%

**

Unmarried

30

20.0%

38

21.0%

25

16.7%

93

19.3%

Widow

0

0.0%

7

3.9%

11

7.3%

18

3.7%

Divorced/separated

0

0.0%

0

0.0%

3

2.0%

3

0.6%

Total

150

100.0%

181

100.0%

150

100.0%

481

100.0%

 

 

 

 

 

Education

Dakhil

6

4.0%

 

 

 

 

 

 

-

Alim

30

20.1%

 

 

 

 

 

 

Fajil

14

9.4%

 

 

 

 

 

 

Kamil

99

66.4%

 

 

 

 

 

 

Total

149

100.0%

 

 

 

 

 

 

 

No education

 

 

52

29.5%

20

13.4%

72

22.2%

**

Primary

 

 

41

23.3%

26

17.4%

67

20.6%

6-10

 

 

28

15.9%

21

14.1%

49

15.1%

11 and more

 

 

55

31.3%

82

55.0%

137

42.2%

Total

 

 

176

100.0%

149

100.0%

325

100.0%

 

 

 

 

 

 

 

Occupation

Madrasa teacher

82

55.8%

 

 

 

 

 

 

-

Imam

33

22.4%

 

 

 

 

 

 

Muazzin

4

2.7%

 

 

 

 

 

 

Others

28

19.0%

 

 

 

 

 

 

Total

147

100.0%

 

 

 

 

 

 

 

Service

 

 

43

24.0%

51

34.5%

94

28.7%

**

Business

 

 

55

30.7%

42

28.4%

97

29.7%

Housewife

 

 

49

27.4%

24

16.2%

73

22.3%

Jobless

 

 

4

2.2%

13

8.8%

17

5.2%

Others

 

 

28

15.6%

18

12.2%

46

14.1%

Total

 

 

179

100.0%

148

100.0%

327

100.0%

Monthly income

 (in Takab)

<10000

51

34.7%

 

 

 

 

 

 

-

10000-20000

84

57.1%

 

 

 

 

 

 

>20000

12

8.2%

 

 

 

 

 

 

Total

147

100.0%

 

 

 

 

 

 

 

<7000

 

 

55

45.1%

60

42.6%

115

43.7%

n.s.

7000-15000

 

 

50

41.0%

67

47.5%

117

44.5%

>15000

 

 

17

13.9%

14

9.9%

31

11.8%

Total

 

 

122

100.0%

141

100.0%

263

100.0%

 

 

Religion

Islam

150

100.0%

 

 

 

 

 

 

 

Islam

 

 

181

95.3%

130

88.4%

311

92.3%

*

Hindu

 

 

8

4.2%

14

9.5%

22

6.5%

Buddhism

 

 

0

0.0%

2

1.4%

2

0.6%

Christian

 

 

0

0.0%

1

0.7%

1

0.3%

Others

 

 

1

0.5%

0

0.0%

1

0.3%

Total

 

 

190

100.0%

147

100.0%

337

100.0%

 

 

No of use of Ayurvedic medicine

a year

0

15

10.6%

1

0.5%

67

45.0%

83

16.8%

**

1-2

27

19.0%

45

22.3%

51

34.2%

123

24.9%

3-4

26

18.3%

100

49.5%

23

15.4%

149

30.2%

5-6

68

47.9%

46

22.8%

8

5.4%

122

24.7%

6 or more

6

4.2%

10

5.0%

0

0.0%

16

3.2%

Total

142

100.0%

202

100.0%

149

100.0%

493

100.0%

 

 

No of use of Orthodox medicine

a year

0

2

1.7%

5

2.6%

3

2.1%

10

2.2%

**

1-2

17

14.3%

94

49.2%

4

2.8%

115

25.3%

3-4

42

35.3%

55

28.8%

39

26.9%

136

29.9%

5-6

46

38.7%

29

15.2%

84

57.9%

159

34.9%

6 or more

12

10.1%

8

4.2%

15

10.3%

35

7.7%

Total

119

100.0%

191

100.0%

145

100.0%

455

100.0%

 

 

Mean

10‰

90‰

Mean

10‰

90‰

Mean

10‰

90‰

 

Expenditure of Ayurvedic medicine

a yearb

1026.7

300

2000

1152.6

200

2550

376.4

000

1230

 

Expenditure of Orthodox medicine

a yearb

3575.8

560

7000

2748.1

500

5000

3707.3

560

5000

 

aKruskal-Wallis test for Age, Monthly income, No. of use of Ayurvedic medicine, and No. of use of Orthodox medicine

χ2-test for gender, Marital status, Education, Occupation, Religion

b1USD =70 Taka

**P < 0.01, *P < 0.05

Table 2. Perception on Ayurvedic medicine (AM) use in Dhaka, Bangladesh

 

Respondents

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

Test

   

n

%

n

%

n

%

n

%

 

AM including HM is effective for -

 

Only male

2

1.4%

2

1.0%

2

1.4%

6

1.2%

n.s.

Only female

4

2.7%

3

1.5%

3

2.0%

10

2.1%

 

Both male and female

140

95.9%

189

97.4%

142

96.6%

471

96.7%

 

Total

146

100.0%

194

100.0%

147

100.0%

487

100.0%

 

Mode of effect of AM including HM

 

Prevention of disease

90

62.1%

45

23.1%

39

26.5%

174

35.7%

**

Treatment of diseases

31

21.4%

73

37.4%

20

13.6%

124

25.5%

 

Promotion of health

18

12.4%

74

37.9%

86

58.5%

178

36.6%

 

Others

6

4.1%

3

1.5%

2

1.4%

11

2.3%

 

Total

145

100.0%

195

100.0%

147

100.0%

487

100.0%

 

How AM including HM works?

 

Eradicate disease

94

64.8%

147

72.8%

46

30.9%

287

57.9%

**

Improve body defense

7

4.8%

51

25.2%

57

38.3%

115

23.2%

 

Keep relax

38

26.2%

1

0.5%

37

24.8%

76

15.3%

 

Remove bad effect of Orthodox medicine

1

0.7%

3

1.5%

3

2.0%

7

1.4%

 

Cures symptoms only

5

3.4%

0

0.0%

6

4.0%

11

2.2%

 

Total

145

100.0%

202

100.0%

149

100.0%

496

100.0%

 

χ2-test was used

**p < 0.01

Table 3. Satisfaction on Ayurvedic medicine (AM) use in Dhaka, Bangladesh

 

Respondents

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

Test

   

n

%

n

%

n

%

n

%

 

Did you get benefit from AM?

 

Yes

133

89.9%

200

99.5%

90

60.0%

423

84.8%

**

No

15

10.1%

1

0.5%

60

40.0%

76

15.2%

 

Total

148

100.0%

201

100.0%

150

100.0%

499

100.0%

 

Did you get harm from AM?

 

Yes

6

4.1%

139

62.2%

0

0.0%

145

29.2%

**

No

142

95.9%

62

30.8%

148

100.0%

352

70.8%

 

Total

148

100.0%

201

100.0%

148

100.0%

497

100.0%

 

Were you satisfied with AM?

 

Very satisfied

6

4.1%

65

36.7%

10

8.9%

81

18.6%

**

Satisfied

137

93.2%

111

62.7%

99

88.4%

347

79.6%

 

Dissatisfied

4

2.7%

1

0.6%

3

2.7%

8

1.8%

 

Total

147

100.0%

177

100.0%

112

100.0%

436

100.0%

 

Did you recommend AM to others?

 

Yes

138

93.9%

198

99.0%

84

57.5%

420

85.2%

**

No

9

6.1%

2

1.0%

62

42.5%

73

14.8%

 

Total

147

100.0%

200

100.0%

146

100.0%

493

100.0%

 

Does anybody help you using AM?

 

Yes

124

88.6%

161

85.6%

15

10.3%

300

63.3%

**

No

16

11.4%

27

14.4%

131

89.7%

174

36.7%

 

Total

140

100.0%

188

100.0%

146

100.0%

474

100.0%

 

Government should take more initiatives to promote AM

 

Yes

105

70.9%

196

100.0%

117

78.5%

418

84.8%

**

No

1

0.7%

0

0.0%

8

5.4%

9

1.8%

 

Existing initiatives are enough

42

28.4%

0

0.0%

24

16.1%

66

13.4%

 

Total

148

100.0%

196

100.0%

149

100.0%

493

100.0%

 

If treatment cost is same, which will you choose?

AM

125

87.4%

180

98.9%

9

6.4%

314

67.5.%

**

Orthodox medicine

18

12.6%

2

1.1%

131

93.6%

151

32.5%

 

Total

143

100.0%

182

100.0%

140

100.0%

465

100.0%

 

χ2-test was used

**p < 0.01

Table 4. Attitudes of the citizens on Ayurvedic medicine (AM) in Dhaka, Bangladesh

 

Respondents

 

 

 

Religious leaders

Outpatients of Ayurvedic medicine

Outpatients of

Orthodox medicine

Total

test

AM provider gives good information on maintaining a healthy lifestyle

 

Strongly disagree

2

1.4%

0

0.0%

0

0.0%

2

0.4%

**

Disagree

2

1.4%

0

1.0%

2

1.3%

6

1.2%

 

Haven't decided

26

17.7%

2

1.0%

84

56.0%

112

22.7%

 

Agree

108

73.5%

55

27.9%

64

42.7%

227

46.0%

 

Strongly agree

9

6.1%

138

70.1%

0

0.0%

147

29.8%

 

Total

147

100.0%

197

100.0%

150

100.0%

494

100.0%

 

Herbal medicine has less side effects

 

Strongly disagree

1

0.7%

0

0.0%

1

0.7%

2

0.4%

**

Disagree

2

1.3%

0

0.0%

1

0.7%

3

0.6%

 

Haven't decided

23

15.4%

2

1.0%

42

28.0%

67

13.5%

 

Agree

111

74.5%

54

27.3%

104

69.3%

269

54.1%

 

Strongly agree

12

8.1%

142

71.7%

2

1.3%

156

31.4%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

AM involves natural plant formulas which are healthier than taking drugs given by the medical doctors

 

Strongly disagree

0

0.0%

0

0.0%

0

0.0%

0

0.0%

**

Disagree

2

1.3%

0

0.0%

1

0.7%

3

0.6%

 

Haven't decided

20

13.4%

4

2.0%

12

8.0%

36

7.2%

 

Agree

115

77.2%

52

26.3%

132

88.0%

299

60.2%

 

Strongly agree

12

8.1%

142

71.7%

5

3.3%

159

32.0%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

People would be more likely to use AM if there were more AM clinics

 

Strongly disagree

1

0.7%

0

0.0%

1

0.7%

2

0.4%

**

Disagree

2

1.3%

1

0.5%

2

1.3%

5

1.0%

 

Haven't decided

10

6.7%

3

1.5%

20

13.3%

33

6.6%

 

Agree

120

80.5%

40

20.2%

127

84.7%

287

57.7%

 

Strongly agree

16

10.7%

154

77.8%

0

0.0%

170

34.2%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

AM build up the body’s own defenses

Strongly disagree

0

0.0%

0

0.0%

2

1.3%

2

0.4%

**

Disagree

3

2.0%

0

0.0%

2

1.3%

5

1.0%

 

Haven't decided

13

8.8%

4

2.0%

43

28.7%

60

12.1%

 

Agree

117

79.1%

42

21.3%

100

66.7%

259

52.3%

 

Strongly agree

15

10.1%

151

76.6%

3

2.0%

169

34.1%

 

Total

148

100.0%

197

100.0%

150

100.0%

495

100.0%

 

The more knowledge a person has on AM, the more likely he/she use it

 

Strongly disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

**

Disagree

1

0.7%

1

0.5%

1

0.7%

3

0.6%

 

Haven't decided

7

4.7%

4

2.0%

39

26.0%

50

10.1%

 

Agree

123

82.6%

53

26.8%

109

72.7%

285

57.3%

 

Strongly agree

17

11.4%

140

70.7%

1

0.7%

158

31.8%

 

Total

149

100.0%

198

100.0%

150

100.0%

497

100.0%

 

Parent(s) can influence youth’s AM use by exposing them to it

 

Strongly disagree

2

1.3%

0

0.0%

0

0.0%

2

0.4%

**

Disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

 

Haven't decided

13

8.7%

5

2.6%

26

17.3%

44

8.9%

 

Agree

109

73.2%

59

30.1%

124

82.7%

292

59.0%

 

Strongly agree

24

16.1%

132

67.3%

0

0.0%

156

31.5%

 

Total

149

100.0%

196

100.0%

150

100.0%

495

100.0%

 

People can be influenced to use AM if friends are using it

 

Strongly disagree

1

0.7%

0

0.0%

0

0.0%

1

0.2%

**

Disagree

4

2.7%

0

0.0%

3

2.0%

7

1.4%

 

Haven't decided

11

7.4%

15

7.7%

30

20.0%

56

11.3%

 

Agree

110

73.8%

53

27.0%

117

78.0%

280

56.6%

 

Strongly agree

23

15.4%

128

65.3%

0

0.0%

151

30.5%

 

Total

149

100.0%

196

100.0%

150

100.0%

495

100.0%

 

Teacher can influence youth’s AM use by exposing them to it

 

Strongly disagree

0

0.0%

0

0.0%

1

0.7%

1

0.2%

**

Disagree

4

2.7%

0

0.0%

2

1.3%

6

1.2%

 

Haven't decided

18

12.1%

21

10.7%

36

24.2%

75

15.2%

 

Agree

108

72.5%

64

32.7%

109

73.2%

281

56.9%

 

Strongly agree

19

12.8%

111

56.6%

1

0.7%

131

26.5%

 

Total

149

100.0%

196

100.0%

149

100.0%

494

100.0%

 

People who believe in the physical, mental and spiritual aspects of health are more likely to use AM

Strongly disagree

4

2.7%

0

0.0%

1

0.7%

5

1.0%

**

Disagree

1

0.7%

1

0.5%

5

3.3%

7

1.4%

 

Haven't decided

12

8.1%

63

32.6%

82

54.7%

157

32.0%

 

Agree

109

73.6%

89

46.1%

58

38.7%

256

52.1%

 

Strongly agree

22

14.9%

40

20.7%

4

2.7%

66

13.4%

 

Total

148

100.0%

193

100.0%

150

100.0%

491

100.0%

 

Those who fear the discomfort of treatment from medical doctors are more likely to use AM

 

Strongly disagree

6

4.1%

11

5.6%

4

2.7%

21

4.2%

**

Disagree

2

1.4%

25

12.6%

30

20.0%

57

11.5%

 

Haven't decided

13

8.8%

113

57.1%

57

38.0%

183

36.9%

 

Agree

109

73.6%

29

14.6%

53

35.3%

191

38.5%

 

Strongly agree

18

12.2%

20

10.1%

6

4.0%

44

8.9%

 

Total

148

100.0%

198

100.0%

150

100.0%

496

100.0%

 

 

 

 

 

 

AM are not harmful

 

Strongly disagree

0

0.0%

18

9.2%

0

0.0%

18

3.6%

**

Disagree

6

4.1%

28

14.3%

4

2.7%

38

7.7%

 

Haven't decided

8

5.4%

98

50.0%

67

44.7%

173

35.0%

 

Agree

114

77.0%

39

19.9%

78

52.0%

231

46.8%

 

Strongly agree

20

13.5%

13

6.6%

1

0.7%

34

6.9%

 

Total

148

100.0%

196

100.0%

150

100.0%

494

100.0%

 

People are mostly motivated to use AM by television, radio and mass media

Strongly disagree

6

4.1%

0

0.0%

0

0.0%

6

1.2%

**

Disagree

2

1.4%

1

0.5%

0

0.0%

3

0.6%

 

Haven't decided

8

5.5%

7

3.5%

9

6.0%

24

4.9%

 

Agree

113

77.4%

49

24.7%

136

90.7%

298

60.3%

 

Strongly agree

17

11.6%

141

71.2%

5

3.3%

163

33.0%

 

 

Total

146

100.0%

198

100.0%

150

100.0%

494

100.0%

 

χ2-test was used

**p < 0.01, *p < 0.05