Evaluation of Herbal Medicine Efficacy and Safety Claims from User’s Perspective: A Qualitative Semi-Structured Interview Study in Abakaliki, Ebonyi State, Nigeria

Abstract

Herbal medicines remain widely used in Nigeria because of their affordability, accessibility, cultural acceptance, and perceived therapeutic benefits. However, increasing commercialization has raised concerns regarding the validity of efficacy claims and the safety of herbal products. This study explored users’ perceptions of the efficacy and safety of herbal medicines among residents of Abakaliki, Ebonyi State, southeastern Nigeria. A qualitative study employing semi-structured in-depth interviews was conducted between July and September 2025 among adult herbal medicine users in Abakaliki. Participants were purposively recruited from churches and selected health centres, with maximum variation sampling used to ensure diversity in demographic characteristics and herbal medicine experiences. Eligibility criteria included being aged 18 years or older, resident in Abakaliki, and having used herbal medicine within the preceding 12 months. Data collection continued until saturation was reached, resulting in 35 participants (51.4% female; mean age 34.7 ± 12.1 years). Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Herbal medicine use was deeply embedded in participants’ health-seeking practices, with most reporting use since childhood. Key perceived advantages included accessibility and availability (n = 28), absence of side effects (n = 25), affordability (n = 22), and ease of self-medication (n = 18). Dissatisfaction with conventional healthcare was linked to high healthcare costs (n = 12) and long waiting times (n = 10). Family members (n = 24) and traditional healers (n = 15) were the primary sources of information. Perceived efficacy was highest for remedies obtained from relatives and trusted traditional practitioners, whereas commercially marketed products were more frequently associated with inconsistent outcomes. Safety concerns were mainly attributed to misuse, contamination, adulteration, and improper preparation rather than the remedies themselves. The findings demonstrate that herbal medicine use is shaped by accessibility, cultural beliefs, and personal experiences. Strengthening regulatory oversight, improving community-based safety education, and incorporating users’ perspectives into policy development may promote the safe and rational use of herbal medicines.