title: How can traditional and complementary medicines be integrated into health care in Saudi Arabia? The perspectives of health professionals and policymakers
Creators: name: Alotaibi, A
Publisher: name: Liverpool John Moores University
Year: 2020

description: The regulation and integration of complementary and alternative medicine (CAM) with orthodox medicine is rapidly gaining interest in medical and policy circles. However, the empirical investigation of CAM is yet to match the growing interest in the field, with a dearth of reliable research on the integration of CAM into national health care systems, particularly within the Middle East and North Africa (MENA) region. Numerous studies of CAM have focused on evidence-based practice and the general effectiveness of specific therapies rather than the prevalence of CAM use (Tovey &amp; Adams, 2003). Aims This study sought to fill this gap in the literature, from the perspective that framing CAM in opposition to orthodox medicine is ultimately problematic and that these types of medicine cannot be mutually exclusive. The exponential growth of CAM use in Saudi Arabia may have created a political need to regulate its practice, particularly regarding integration with orthodox medicine, a lack of evidence exists with respect to the prevalence and nature of CAM practice in the nation. With that in mind, this study was designed to assess CAM practice within the Saudi Arabian health care system from the perspective of physicians, hospital managers and policymakers in the Ministry of Health. The study also aimed to align health care regulations for CAM practice in Saudi Arabia with the World Health Organization’s (2012) guidelines concerning safety, effectiveness and quality of CAM. Methods This thesis used a mixed-methods design to investigate doctor and stakeholder perceptions of CAM integration into the health care system of Saudi Arabia and how it relates to policy and culture. In the first phase, a questionnaire was distributed to randomly selected hospitals and primary health care centres (PHCs) in both rural and urban areas in selected regions. The questionnaire investigated physician knowledge and perception of CAM’s safety, effectiveness and quality. Results indicated a continuous and substantial progression towards integration of CAM in Saudi Arabia. A sizeable percentage of participants believed that CAM is more effective than Islamic medicine (IM). The second phase of the study involved interviewing 30 physicians about their attitudes toward CAM to identify their preferences, rationale and feelings toward integration. Most interviewees supported integration with the view that it could improve safety, but many doubted the efficacy of CAM practices. In the third phase of the study, five hospital administrators and stakeholders participated in semi-structured interviews aimed at identifying and understanding the efforts undertaken in integrating CAM in the Saudi health care system. Results All interviewees thought CAM integration was a desirable goal, but that the lack of evidence-based research, support and training for physicians could slow the process. Considerable efforts are still required to fully integrate CAM in the Saudi health care system, despite the numerous published data showing that CAM is extensively used in the country. The use of CAM is common among clerics rather than physicians; examples of CAM practices in Saudi Arabia and other Islamic and Arab countries include honeybee products, herbs, prayer and wet cupping. Most of these practices are termed ‘prophetic medicines’ Conclusion With more physicians and patients embracing CAM, it is only prudent that the best evidence is employed to pre-empt conflict arising from its adoption. This study augments and adds more depth to the currently available literature on CAM practice in Saudi Arabia.