Traditional Medicine in Asia

A framework for cost-benefit analysis of traditional medicine and conventional medicine
traditional birth attendant (TBA) training in
Nigeria attracted resentment from underfunded
rural midwives as resources were
given to birth attendants when maternity
centres lacked equipment. 56
Another potential conflict is that if THC
services are made available under medical
insurance schemes, those who can afford
to pay for insurance will be the greatest
beneficiaries of TRM. The poor may be
relegated to purchasing unregulated drugs
from unlicensed street vendors, as already
happens in so many poor countries. This
would stand in contrast to the customary
role of TRM serving as the first and last
resort for available health care for the poor.
A further risk is that primary health care
services in TRM may remain marginal and
under-funded due to the tendency of
national health budgets favouring tertiary
care. In Cote D’Ivoire, the rich receive more
assistance than the poor, because the
poorest patients rarely use anything but
primary care, whereas the Government
provides generous subsidies for the tertiary
level, which in practice serves the richest
patients. 57 Average per capita spending on
consultations differs by a ratio of 1:300
between the first and tenth deciles. The
spread is extreme (1:3000) in the case of
expenditures on hospitalization. It has been
argued that there is injustice in the high
allocation of resources to tertiary care, when
household expenditures on TRM and
modern medicine indicate the demand and
need at the primary care level (see Figure 3).
Differential allocation of resources to
areas of high priority might be one solution
An older woman I knew in Papua New Guinea did not perform any visible
economic activity, being old and weak. On the surface she consumed rather
than produced resources; thus there was little incentive to spend still more
on maintaining her health.
But what of the value of her knowledge and wisdom in the resolution of family
conflicts?
What of her value in the education of the children through myths, storytelling
and personal history?
What of her knowledge of herbal and household remedies for common
illnesses?
How to assess in monetary terms the fact that she can call upon the support
of other community members in times of hardship, just as she has assisted
them in times past?
These are vital contributions to the continued health of her community, but
we have a long way to go before we can cost them.
Too often the economic spotlight is turned upon the more straightforward
task of assessing the cost of her arthritis or her chronic obstructive lung
disease: inevitably, she shows up as a negative item on the balance sheet.
(Hill, 1997) (55)
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