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Alternative treatment refers to health-care interventions developed and guided by ethnocultural and/or religious beliefs and principles. The World Health Organization estimates that, in Nigeria, as in other developing countries, up to 80 per cent of the population uses alternative treatment methods to meet their health-care needs [1]. Alternative treatment services are generally acceptable, accessible and affordable, especially in comparison with western and orthodox medical services [2].
While anecdotal evidence abounds regarding the nature, effects and outcomes of alternative treatment programmes, there exists a dearth of empirical evidence about existing alternative treatment practices (both orthodox and unorthodox) that would form the basis for engagement with alternative treatment providers. The objective of the present study was to assess alternative substance use disorder treatment services that exist and to examine principles, methods and practices used in the treatment of patients suffering from substance use disorders. The study employed cross-sectional qualitative methods to evaluate 27 alternative addiction treatment centres selected specifically in northern and southern Nigeria. Most of the centres (82 per cent) described their treatment approach as being based on a combination of traditional, cultural and religious concepts. The average number of staff members was 10 but varied widely, with some centres run by the proprietor alone, while others had up to 25 staff members. The patient capacity of the centres also varied widely, from small centres with capacity for four patients to centres with capacity for 350 patients. The centres also varied considerably in the maximum duration of time that patients spent in their care, from two weeks to up to four years. The majority of the centres believed that, in general, addiction resulted from spiritual causes and often involved demonic (or malignant) spirit forces, and their practices were developed in response to that belief. A notable finding of the present study, in all the centres visited, was the absence of documentation regarding treatment service processes. None of the centres created or stored written records of treatment and assessment protocols or updated treatment plans created with the involvement of the patients. Our findings support an urgent need for engagement with alternative treatment providers in the short term to establish a “documentation system” that would serve for improved patient services at the centres and provide critical data for a process and outcome evaluation of their practices. Such a documentation system is also important for further studies into alternative treatment services available for women in northern Nigeria, in particular in the areas that we visited.
