BackgroundOver the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process.MethodsQualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants’ interviews was employed to collect data.ResultsPolicies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital.ConclusionsThe lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

The use of herbal products has increased and become more popularized globally; however, limited studies coupled with questions related to the quality and safety of these herbal products have been raised. Herbal products with hope of their nontoxicity may play a role of alternative to overcome the problems of multi-drug resistant pathogens. Medicinal plants used as raw materials for production may have quality and safety issues due to proximity to wastewater application of fungicides and pesticides, which may be directly deposited superficially or absorbed by the plant system. Therefore, possible contamination of some Ghanaian herbal products cannot be ignored, as it may severely affect human life in the process of treatment. Aim. To evaluate the microbial load and the presence of toxic heavy metals in Mist Amen Fevermix and Edhec Malacure, two polyherbal products used in the treatment of uncomplicated malaria in Ghana. Methods. Thermo Elemental M5 Atomic Absorption Spectrophotometer (AAS) fitted with graphite furnace and an auto sampler was used to determine the heavy metal contents of the herbal products. The herbal samples were evaluated for the microbial load by using the appropriate culture media. Results and Analysis. Mist Amen Fevermix and Edhec Malacure complied with the safety limits evaluated for all different microbial counts and contamination. The following heavy metals were present in Mist Amen Fevermix and Edhec Malacure Mixture: Fe, Ni, K, Zn, Hg, Cu, Mn, Cr, Cd, Pb, Fe, Cu, K, and Na. Ni was below detectable limit in Edhec Malacure. Conclusion. Mist Amen Fevermix and Edhec Malacure may be assured of safety. The products contained heavy metals, but all were within acceptable limit established by the FAO/WHO. The levels of microbial contamination were below the maximum acceptable limit.

Malaria is a public health challenge that requires prompt treatment for those infected to make a full recovery. Treatment of malaria infection is to be started as soon as a diagnosis is confirmed. Antimalarial medications are administered to prevent and also to treat malaria. The type of medication used and the duration of therapy is dependent on the type of malaria-causing plasmodium species, the severity of the symptoms, geographical area where malaria infection occurred and the medication used to prevent malaria and whether there is pregnancy. Treatment of malaria from public health perspective is to reduce transmission of the infection to others, by reducing the infectious reservoir and to prevent the emergence and spread of resistance to antimalarial medicines. Medications used in the treatment of malaria infection come from the following five groups of chemical compounds: quinolines and aryl amino alcohols, antifolate, artemisinin derivatives, hydroxynaphthoquinones and antibacterial agents. The treatment of malaria is not initiated until the diagnosis has been established through laboratory testing. Artemisinin-based Combination Therapy (ACTs) has been used for the treatment of uncomplicated malaria. ACTs are also to enhance treatment and protect against the development of drug resistance. IV artesunate is used in the treatment of severe malaria, regardless of infecting species.

Background: For therapeutic purposes, local markets serve as the main trading center of medicinal plants for both traditional medicine practitioners and the general public. However, there is still limited information about the plant species and their derivatives traded outside larger markets in major cities. This study aimed to take inventory of the plant species traded for medicinal purposes in a traditional market outside a major city and determine their applications through vendors' familiarization.Methods: An inventory of plant species traded for medicinal purposes in the Ho Central Market was undertaken, coupled with a semi-structured interviews on their applications based on the vendor's familiarization. Quantitative ethnobotanical indices were used to determine the most culturally important species.Results: A total of 60 plant species from 37 families was documented to be traded in the Ho Central Market. The Adansonia digitata, Thaumatococcus daniellii and Zanthoxylum zanthoxyloides were recorded to have the highest frequency of citations. The highest use report (UR) and cultural importance (CI) values were recorded for Z. zanthoxyloides. Body pains, blood tonic (anemia), and abdominal pains were the most prominent conditions that traded plants were used to treat. Conclusion:The study revealed a total of 60 medicinal plants which is commonly sold in the Ho Central Market and other major markets in the country, which was attributed to idiosyncrasy in cultural knowledge about the application of the plants. The market served as a venue for information exchange and learning, resulting in the high uniformity of vendors' familiarization with plant application and that of traditional medicine practitioners.

There has always been a strong human dependency on plants for health purposes and such an important relationship should be sustained. Plants remain a repository of drug leads for discovering new pharmaceutical agents for prevention, treatment and improving the quality of health for many people globally. In the effort to improve healthcare services, Ghana put up the Recommended Essential Herbal Medicine List (REHML) consisting of products that are used in the treatment of both Communicable and non-Communicable diseases. To inspire confidence among prescribers and clients of the products it has become necessary to validate the plants and their products. The aim of the study was to identify the medicinal plants' species in the herbal products in Ghana’s REHML commonly used for treatment, the conditions being treated with them and finding published research for the plants therapeutic use. Medicinal plants on the REHML with chances of getting extinct were also assessed. The REHML of Ghana and the Ghana Herbal Pharmacopoeia were reviewed for the required information. Electronic databases; PubMed and Scopus, as well as online search engines, Google Scholar and Google were used to obtain information on the identified medicinal plants and their families. A total of 167 medicinal plant species were found to be used in 180 products as compiled in the Ghana REHML and these belonged to 63 botanical families. Most of the medicinal plants are collected from the wild making sustainability and bio-conservation a challenge. Decoctions, creams and ointments are the commonest dosage forms. The REHML of Ghana caters for 13 disease areas using 180 finished herbal products. These products are made from 167 medicinal plants, 16 of which are in the group of medicinal plants classified as endangered species. There should be a conscious effort to bio-conserve these endangered medicinal plant species so that there can be continuous supply for use in the preparation of herbal products for healthcare purposes.