Prevalence and drivers of medicinal tree use in Tolon District, Northern Ghana

Abstract

Background: In the rural communities of Ghana, traditional medicine (TM) is the principal means of obtaining primary healthcare. District-level on the utilization of TM, its drivers, knowledge transmission and priority medicinal tree species in Northern Ghana are scarce. This study assessed the prevalence and drivers of medicinal tree use in six purposively selected communities in the Tolon District, Northern Ghana.

Methods: A cross-sectional survey was conducted between June to December 2024 over a period of four months in six communities in Tolon District, Ghana with 247 respondents. Communities were purposively selected based on their high reported TM use. Within each community, respondents were selected using a systematic random sampling technique from household lists, targeting household heads or adult members above 18 years with knowledge of medicinal plant use. Data were documented on prevalence and patterns of medicinal tree utilization, drivers of use and priority medicinal tree species. Descriptive statistics, Kruskal-Wallis tests, Structural Equation Modeling (SEM), Non-metric Multidimensional Scaling, Canonical Correspondence Analysis (CCA), PERMANOVA, co-occurrence network analysis and Random Forest Modelling (RFM) were performed. Ethnobotanical indices including Frequency of Citation, Relative Frequency of Citation (REC), and Fidelity Level were calculated. All RFC values were recalculated using N=247.

Results: Among respondents in the six study communities, 235 reported TM use in last 12 months, giving a prevalence of 95.1% (95% CI: 91.8-97.1%) in the study communities. Due to purposive sampling, this is not generalizable to the entire Tolon District. The dominant driver was perceived effectiveness (Relative Importance Index, RII=0.861, 95% CI: 0.842-0.879)   which explained 38.4% of variance in Dominance Analysis. Plant knowledge composition was significantly structured by ethnicity (PERMANOVA R²=0.18, p=0.001) and age (R²=0.09, p=0.001). Distance from health center and community explained 28.4% of the variation in plant use in CCA. Random Forest Modelling identified Age and Ethnicity as top predictors of plant knowledge, explaining 61.3% of variance. Twenty medicinal plant species were documented with Azadirachta indica as a cultural keystone species. Perceived Knowledge Loss Index (PKLI) showed elders >55 years held 82% more knowledge than perceived youth in 18-30 year group.

Conclusion: Traditional medicine use in the study communities was associated with belief in effectiveness and was spatially and culturally structured. This study provided district-level evidence in Northern Ghana linking people, plants and environment using multivariate statistics. T The observed disinterest among youth is ironic given that at least 50% of modern medicines are derived from traditional medicines.

Keywords: Traditional Medicine; Ghana; Prevalence; Drivers; Medicinal Trees; Knowledge Loss; Tolon District; Guinea Savanna