Use of traditional medicine in Lao PDR.

OBJECTIVES: Exploring the attitudes and knowledge of household members and health staff in Lao PDR regarding the use of traditional medicine. BACKGROUND: Along with modern medicine, traditional medicine utilisation is officially supported in Laos, being part of the cultural heritage and considered useful for this low-income country in relation to the problems with access to modern pharmaceuticals. METHODS: The study population comprised 600 households from one lowland (Pakse) and one mountainous (Paksong) district. In a stratified two-stage sampling procedure, household surveys were conducted and focus group discussions (FGD) were performed among health staff and villagers in the same districts. RESULTS: Seventy-seven per cent of the households stated the ever use of traditional medicine including herbal medicines, sauna, massage and acupuncture. The main reason given was perceived efficacy. Traditional medicine was used for both chronic and acute diseases. The FGD revealed the perceived need to have training courses for traditional medicine providers and to have a medicinal garden in the villages. Utilisation was similar in lowland and mountainous districts as well as in urban and rural areas. CONCLUSIONS: The study indicates that traditional medicine is widely used and perceived as effective by a fairly large proportion of Lao people. The findings may form a basis for health sector reforms that are congruent with perceived local needs, e.g. in establishing a strategic plan for the development of the traditional medicine sector in Lao PDR.

Decision-makers and the usefulness of research evidence in policy implementation--a case study from Lao PDR.

The involvement of researchers in the policy process and policy-makers in research is little studied, particularly in developing countries. In 1993, the Lao National Drug Policy (NDP) was endorsed in a consultative process involving many stakeholders. Lao People's Democratic Republic is a poor country in South East Asia. Five pilot provinces were selected for implementation of the policy, which had a health system research (HSR) component. This case study explores decision-makers' knowledge and attitudes regarding the usefulness of HSR in the NDP implementation process. Ninety decision-makers from different health institutions including hospitals, medical schools and main drug suppliers were surveyed using a self-administrated structured questionnaire, filled in during a NDP conference in 2001. Results from six HSR projects related to the NDP implementation had been presented during the conference, but also 6 months previously and through written reports. There were 75 respondents (83% of attendees, 90% of whom were men), 39% with medical, 50% with pharmacy and 11% with other background. Ninety-eight percent of the participants found operational research useful, and 87% supported it to be an element of the NDP. Two-thirds knew the objectives of the NDP. There was no significant difference in knowledge and attitudes between pilot and non-pilot provinces and between professions. Ninety-two percent were aware of the Essential Drug List, and 88% found it adequate to drug need. Ninety-seven percent agreed with generic drug prescribing. Seventy percent reported to have heard about Good Pharmacy Practice (GPP), but only a few could explain it. Although most participants agreed that HSR should be one main component of the NDP and found HSR results useful, few had heard about them before the conference, and research was not well understood. The paper discusses various factors influencing decision-makers' perceptions of usefulness of research in this case during the NDP implementation process. It is concluded that the acceptance of research and major NDP concepts probably is a result of close interaction between researchers and policy-makers and that the interface between research and policy-making needs further studies.