CoAuthor: Christa Maria Joel, Meera Ann John, Suzanna Rimai, Sneha Antony, Viona DSouza. Moderator- Dr. Saurabh Kumar Department of Community Medicine Father Muller Medical College 3rd Year MBBS

1. A comparative study of the practice of complementary
medicine among people of different educational status in
Mangalore, Karnataka
ABSTRACT
Background and Aim: Complementary medicine has been practiced in India for
thousands of years. The aim of the research is to evaluate the extent of use, perception
and attitude of the community with different educational status in utilizing
complementary medicine especially Ayurveda and Herbal medicine.
Method: A cross sectional study was done on 297 people from various villages in
Mangalore, Karnataka, South India. A door to door survey was done among them to
determine the extent of usage, awareness, perception and success of the treatment.
Results: When a comparative study was done among people of different educational
background, it was found that people with secondary education was the most that used
Ayurveda as the complementary medicine with a prevalence of 36.7%. Coming to
Herbal medicine it is being used most commonly among the illiterate that is 57.1% used
this therapy.
Conclusion: This study found a high usage of Herbal medicine among the illiterate and
the usage of Ayurveda among people with secondary education. This underlines the
need for educating the people about the adverse effects and risk factors of these
medicines.
KEYWORDS: complementary medicine, Ayurveda, Herbal medicine, illiterate,
secondary education
INTRODUCTION
Complementary medicine is defined as a group of diverse medical and health care
systems, practices and products that are presently not considered to be a part of
conventional medicine, as such, the relevant principles and skills are not included in the
curricula of conventional medical education programmes. It focuses on the whole
person: their lifestyle, environment, diet and mental, emotional and spiritual health, as
well as physical complaints.
Complementary medicine refers to healing practices and products that work in
conjunction with traditional medicine. For example, a cancer patient receiving
chemotherapy may also undergo acupuncture to help manage chemo side effects like
nausea and vomiting.

2. It is being increasingly used by people all over the world. Women, people aged 40-60
and adults with higher level of education and income tended to use complementary
medicine more frequently in developed countries.
Although complementary medicine has been practiced in India for thousands of years,
there is limited literature available on the extent of use, attitude and perception of
patients using complementary medicine in India.
An increasing amount of research is being done to establish the safety and efficacy of
complementary medicine. But compared with traditional ‘Western therapies’ such as
drugs, research on this complementary medicine is still limited. Despite the limited
knowledge, there is growing tendency among the people for the use of complementary
medicine.
Some of the complementary therapies used in India are Ayurveda, homeopathy,
manipulation, herbal medicine, spiritual healing and yoga. Here we are trying to assess
the usage of Ayurveda and herbal medicine among the rural people in Mangalore.
Ayurveda: It came from the Vedic civilization in India, 4000 years ago. Ayurveda means
‘Science of life’. It is focused on extending the lifespan of each individual preventing
disease and replenishing the body. Ayurveda uses life style modifications and natural
therapies such as nutrition, herbs, minerals, exercise, stretching, aromatherapy,
meditation and massage to balance the body. Applications- for headaches/ migraines,
detoxification of the body, insomnia, pain, depression, anxiety, digestive disorders,
fatigue, central nervous system problems, arthritis and skin allergies.
Herbal medicine: Herbal medicine, also called botanical medicine or phytomedicine,
refers to using a plant's seeds, berries, roots, leaves, bark, or flowers for medicinal
purposes. Ancient Chinese and Egyptian papyrus writings describe medicinal uses for
plants as early as 3,000 BC. The use of herbal supplements has increased dramatically
over the past 30 years. Practitioners often use herbs together because the
combination is more effective. Health care providers must take many factors into
account when recommending herbs, including the species and variety of the plant, the
plant's habitat, how it was stored and processed, and whether or not there are
contaminants (including heavy metals and pesticides). Herbal medicine is used to treat
many conditions, such as allergies, asthma, eczema, premenstrual syndrome,
rheumatoid arthritis, fibromyalgia, migraine, menopausal symptoms, chronic fatigue,
irritable bowel syndrome, and cancer, among others.
METHODS
Subjects were selected from villages in the rural areas of Mangalore, Karnataka,
South India. The study population consisted of 297 people, male and female of different
educational status. Subjects were illiterate, literate, people with primary education,
secondary education, graduation and above. To find out which type of complementary
medicine influenced people’s choice for treatment, a questionnaire was designed. The
first part contained questions related to demographic and socioeconomic factors like

3. name, age, education, occupation, religion, income and a brief medical history. The
interview continued with questions related to the occurrence of an illness in the past 3
months and the mode of treatment taken to overcome this ailment.
Data was analyzed using SPSS version 19.0. Descriptive statistics were used to study
the population in terms of frequency distributions for educational status and
complementary medicine used. Chi square test were used to compare groups in terms
of educational status and the complementary medicine used.
RESULTS
The subjects in our study population belonged to various age groups ranging from 16
years to 80 years. Majority belonged to the Hindu religion and were below the poverty
line.
Subjects who were using Ayurveda as a mode of treatment were mainly people with
secondary education. 36.7% people who used Ayurveda had secondary education
followed by 30% illiterate people, 20% people with primary education, 6.7% people with
higher secondary education and 6.7% people who were literate. None of the people with
graduation and above is using Ayurveda.

4. Crosstab
Ayur CTP
Total
Yes No
Education of
subject
Illiterate Count 9 49 58
% within Education of
subject
15.5% 84.5% 100.0%
% within Ayur CTP 30.0% 20.6% 21.6%
Literate Count 2 9 11
% within Education of
subject
18.2% 81.8% 100.0%
% within Ayur CTP 6.7% 3.8% 4.1%
Primary Count 6 72 78
% within Education of
subject
7.7% 92.3% 100.0%
% within Ayur CTP 20.0% 30.3% 29.1%
Secondary Count 11 71 82
% within Education of
subject
13.4% 86.6% 100.0%
% within Ayur CTP 36.7% 29.8% 30.6%
Higher
secondary
Count 2 21 23
% within Education of
subject
8.7% 91.3% 100.0%
% within Ayur CTP 6.7% 8.8% 8.6%
Grad & Above Count 0 16 16
% within Education of
subject
.0% 100.0% 100.0%
% within Ayur CTP .0% 6.7% 6.0%
Total Count 30 238 268
% within Education of
subject
11.2% 88.8% 100.0%
% within Ayur CTP 100.0% 100.0% 100.0%
Subjects who used herbal medicine were mainly illiterate. 57.1% of the illiterate subjects
used herbal medicine. 14.3% of the subjects with primary education, 14.3% of the
subjects with secondary education and 14.3% of the subjects who were literate also
used herbal medicines. None of the subjects with higher education, graduation and
above used this therapy.

5. Crosstab
Herb CTP
Total
Yes No
Education of
subject
Illiterate Count 4 49 53
% within Education of
subject
7.5% 92.5% 100.0%
% within Herb CTP 57.1% 19.5% 20.5%
Literate Count 1 10 11
% within Education of
subject
9.1% 90.9% 100.0%
% within Herb CTP 14.3% 4.0% 4.3%
Primary Count 1 76 77
% within Education of
subject
1.3% 98.7% 100.0%
% within Herb CTP 14.3% 30.3% 29.8%
Secondary Count 1 77 78
% within Education of
subject
1.3% 98.7% 100.0%
% within Herb CTP 14.3% 30.7% 30.2%
Higher
secondary
Count 0 23 23
% within Education of
subject
.0% 100.0% 100.0%
% within Herb CTP .0% 9.2% 8.9%
Grad & Above Count 0 16 16
% within Education of
subject
.0% 100.0% 100.0%
% within Herb CTP .0% 6.4% 6.2%
Total Count 7 251 258
% within Education of
subject
2.7% 97.3% 100.0%
% within Herb CTP 100.0% 100.0% 100.0%

6. DISCUSSION
Health education is a social science that draws from the biological, environmental,
psychological, physical and medical sciences to promote health and prevent diseases,
disability and premature death through education driven voluntary behavior change
activities. Health education is the development of individual, group, institutional,
community and systemic strategies to improve health knowledge, attitudes, skills and
behavior. The purpose of the health education is to positively influence health behavior
of individuals and communities as well as the living and working conditions that
influence their health.
Right knowledge of medical therapies should be imparted to people to choose their
mode of treatment for ailments. In a country like India, where many tend to use
complementary medicine as their choice of treatment, people should know about the
pros and cons of this therapy. Many patients use Ayurveda or herbal medicine along
with allopathy treatment. But the truth is that they never speak about this to the
physician. There are chances of interaction of the medicines. Also many times it may
nullify the positive effect of the allopathy treatment. A piece of advice for the physician-
it is very important to find out the prior history of complementary medicine while taking
treatment history before reaching on any conclusion during diagnosis. Attractive

7. features of complementary medical practice include greater accessibility, cultural
acceptance in low and middle socioeconomic class, comparatively low cost and often a
lesser need for modern technology.
Ignorance of the pros and cons of complementary medicine can lead to disaster. For
example, a patient affected by tuberculosis has no other option other than going for the
DOTS therapy. But if he opts for complementary medicine it will only worsen the
condition and can lead to death.
In the case of our survey done in Mangalore villages where many tend to use herbal
medicines and Ayurveda, it is a must that they should have a thorough knowledge of the
same. As per our survey, many of them are taking Ayurveda medicine for diseases like
acute gastritis and they find it very helpful. But there are also some cases in which they
are using Ayurveda along with allopathy. Many tend to use Ayurveda because they fear
about the side effects of allopathy. Many of the subjects who use Ayurveda as their
treatment are secondary educated. Since they are educated they tend to know the ill
effects of allopathy. But they give more importance to the ill effects of allopathy, ignoring
the necessity and effectiveness of allopathy for various ailments. And also because of
the advertisements and hype of Ayurveda and its adjoining treatments many are
attracted to it. Since the subjects are educated they can be given an awareness of their
present treatment and alleviate the fear of allopathy treatment.
Regarding the usage of herbal medicine, it is a usual practice in India to do home
remedies for ailments like cold, cough, etc. Over the past few years the usage of herbal
medicine has come to a rise. People have a feeling that it is very safe and also cost
effective. Many times people tend to treat themselves with herbal medicine because
they don’t want to consult a RMP. In the case of our survey, many tend to practice
herbal therapy for acute as well as chronic diseases. As per some of them they find it
consoling but it was not a complete cure for their disease. Most of the herbal medicine
users in our survey are illiterate. Ignorance of the right treatment is evident and
indicates the need for a proper health education. Since the subjects here are illiterate it
is a must they should have a knowledge of allopathy treatment for various ailments
where only allopathy is effective.
Health education is an essential tool of community health. Health education in rural
communities is one of the main ways in which developing countries are addressing
prevalent health issues like maternal and child health care, HIV/AIDS, TB and malaria.
In many rural villages, community health workers act as proxies through which health
education information is spread in their communities. A model of health education
content has to be prepared by professionals who serve the rural community. The
content has to be prepared in the local language and should explain about the pros and
cons of using only complementary medicine. They should give advices on how to use
this therapy and for which all diseases it can be used for. And it should advise the
people to go for mainstream treatment for major diseases like cancer, hepatitis B, etc.
They should explain about the risk factors and mode of transmission of the diseases

8. that cause stigma in the society and educate more about them. They should dispense
the knowledge in a pictorial form by distributing pamphlets so that the illiterate
community can comprehend more. For the people with other educational status, mini
libraries should be established which is accessible to all in that community where health
videos have to be shown. Printed books and pamphlets should be kept there for the
awareness of the people.
To conclude this research study, we emphasize study on the importance of more
research in the area of the usage of complementary medicine among the village
population of Mangalore, Karnataka. We do not rule out the effectiveness of
complementary medicine but it is not a permanent solution for many ailments. Imparting
knowledge about medical treatments is a must to these people.
Let us all look forward for a healthy population.