DOI: https://doi.org/10.14710/nmjn.v15i1.67666

Exploring the Acceptability of Traditional Medicine Clinic Implementation in Indonesian Public Health Centers

*Sri Mumpuni Yuniarsih  -  Nursing Department, Faculty of Health Sciences, Universitas Pekalongan, Indonesia
Retna Siwi Padmawati scopus  -  Department of Health Behavior, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
Ema Madyaningrum scopus  -  Department of Mental Health and Community Health Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia
Yodi Mahendradhata scopus  -  Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: The WHO encourages integrating traditional medicine into healthcare services, recognizing its cultural importance in countries like Indonesia. However, this integration needs improvement to ensure quality and accessibility. Previous research has primarily focused on policy implementation or health outcomes, with limited exploration of the acceptability of traditional medicine clinics in Primary Health Centers (PHCs) from stakeholders’ perspectives using the Theoretical Framework of Acceptability (TFA). Operational and ethical challenges in this integration remain underexplored.

Purpose: This study aimed to explore the acceptability of traditional medicine clinics in PHCs using the TFA, focusing on the perspectives of healthcare workers, traditional medicine practitioners, and patients.

Methods: An exploratory qualitative study was conducted in five PHCs in Boyolali, Central Java, involving 25 participants (healthcare workers, traditional medicine practitioners, and patients). Participants were purposively selected based on the following inclusion criteria: (1) healthcare workers providing services in traditional medicine clinics at PHCs, (2) traditional medicine practitioners operating within the clinic area, and (3) patients who had used the clinic's services at least once. Data were collected through in-depth interviews and analyzed thematically.

Results: Thematic analysis identified four key themes: (1) Perceived Benefits and Trust in TM Clinics, with participants reporting high satisfaction and trust in the services; (2) Readiness and Competency of Healthcare Workers, emphasizing confidence, ongoing training, and collaboration with traditional medicine practitioners; (3) Barriers to Acceptability and Implementation, including heavy workloads, limited resources, and a lack of dedicated personnel; and (4) Alignment with Professional and Cultural Values, focusing on the importance of cultural integration and ethical considerations for the sustainability of TM clinics.

Conclusion: Traditional medicine clinics in PHCs are generally well accepted, but their sustainability depends on addressing resource constraints and enhancing staff training. Strategic investment and policy support are essential to overcoming operational and ethical challenges and ensuring successful integration into public health services.

Note: This article has supplementary file(s).

Fulltext |  common.other
Untitled
Subject
Type Other
  Download (B)    Indexing metadata
Keywords: Healthcare integration; Public Health Centers (PHCs); Theoretical Framework of Acceptability (TFA); traditional medicine

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Coping Strategies of Women with Breast Cancer Undergoing Chemotherapy During the COVID-19 Pandemic: A Qualitative Study Factors Related to Fatigue among Chronic Kidney Disease Patients on Hemodialysis A Pilot Study on Diabetes Distress, Insulin Growth Factor-I, Insulin-Like Growth Factor Binding Protein-3, and HbA1c in Diabetic Patients More recent articles
Most cited articles
Spirituality Intervention and Outcomes: Corner stone of Holistic Nursing Practice A Systematic Review of the Selected Evidences on the Effectiveness of Inter-professional Education (IPE) in Developing Interprofessional Learning Environment Dyspnea Experience and Dyspnea Management in Patients with Chronic Obstructive Pulmonary Disease in Bangladesh Development of Foot Massage Program on Nausea and Vomiting for Cancer Patients: A Literature Review Family Experiences of Mental Illness: A Meta-Synthesis More cited articles
  1. Afrita, I., Yetti, Y., & Arifalina, W. (2020). Medical Environmental Competitiveness: Law Protection for Patient and Traditional Alternative Medicine Practitioners. IOP Conference Series: Earth and Environmental Science, 469(1), 1–5. https://doi.org/10.1088/1755-1315/469/1/012043
  2. Ampomah, I. G., Malau-Aduli, B. S., Seidu, A. A., Malau-Aduli, A. E. O., & Emeto, T. I. (2021). Perceptions and experiences of orthodox health practitioners and hospital administrators towards integrating traditional medicine into the Ghanaian health system. International Journal of Environmental Research and Public Health, 18(21), 1–24. https://doi.org/10.3390/ijerph182111200
  3. Barbieri, V., Lombardo, S., Gärtner, T., Piccoliori, G., Engl, A., & Wiedermann, C. J. (2024). Trust in Conventional Healthcare and Utilization of Complementary and Alternative Medicine in South Tyrol, Italy: A Population-Based Cross-Sectional Survey. Annali Di Igiene Medicina Preventiva e Di Comunita, 36(4), 377–391. https://doi.org/10.7416/ai.2024.2605
  4. Casale, M., Somefun, O., Haupt Ronnie, G., Desmond, C., Sherr, L., & Cluver, L. (2023). A conceptual framework and exploratory model for health and social intervention acceptability among African adolescents and youth. Social Science & Medicine, 326, 115899. https://doi.org/10.1016/J.SOCSCIMED.2023.115899
  5. Chang, S. C., Lin, C. F., Yeh, T. C., & Chang, C. W. (2019). Determinants of the performance of traditional Chinese medicine clinics in Taiwan. Health Policy, 123(4), 379–387. https://doi.org/10.1016/j.healthpol.2019.01.009
  6. Fanda, R. B., Probandari, A., Kok, M. O., & Bal, R. A. (2025). Managing medicines in decentralization: discrepancies between national policies and local practices in primary healthcare settings in Indonesia. Health Policy and Planning, 40(3), 346–357. https://doi.org/10.1093/heapol/czae114
  7. Gyasi, R. M., Asante, F., Yeboah, J. Y., Abass, K., Mensah, C. M., & Siaw, L. P. (2016). Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana. International Journal of Qualitative Studies on Health and Well-Being, 11(29667), 1–12. https://doi.org/10.3402/qhw.v11.29667
  8. Hunter, J., Harnett, J. E., Chan, W.-J. J., & Pirotta, M. (2023). What is integrative medicine? Establishing the decision criteria for an operational definition of integrative medicine for general practice health services research in Australia. Integrative Medicine Research, 12(4), 100995. https://doi.org/https://doi.org/10.1016/j.imr.2023.100995
  9. Kenu, A., Kenu, E., Bandoh, D. A., & Aikins, M. (2021). Factors that promote and sustain the use of traditional, complementary and integrative medicine services at LEKMA hospital, Ghana, 2017: an observational study. BMC Complementary Medicine and Therapies, 21(14), 1–10. https://doi.org/10.1186/S12906-020-03185-Y/FULLTEXT.HTML
  10. Koyuncu, H., Bükülmez, A., & Oflu, A. (2024). Evaluation of the Attitudes of Vaccination-hesitant Parents Towards Complementary and Alternative Medicine. Turk Osteoporoz Dergisi, 22(1), 58–64. https://doi.org/10.4274/jcp.2024.66743
  11. Lee, L., Lewis, C. M., & Montgomery, S. (2020). Clinic-Based Community Health Worker Integration: Community Health Workers’, Employers’, and Patients’ Perceptions of Readiness. Journal of Ambulatory Care Management, 43(2), 157–168. https://doi.org/10.1097/JAC.0000000000000320
  12. Lee, L., Montgomery, S., Gamboa-Maldonado, T., Nelson, A., & Belliard, J. C. (2019). Perceptions of organizational readiness for training and implementation of clinic-based community health workers. Journal of Health Organization and Management, 33(4), 478–487. https://doi.org/10.1108/JHOM-06-2018-0158
  13. Lin, S. K., & Lai, J. N. (2024). Enhancing Traditional Chinese Medicine healthcare system in Taiwan post-COVID-19 pandemic: A strategic focus on specialization. Journal of the Formosan Medical Association, 123(3), S207–S214. https://doi.org/10.1016/j.jfma.2024.09.012
  14. Liu, X., Qian, Z., Li, Y., Wang, Y., Zhang, Y., Zhang, Y., & Enoch, I. V. M. V. (2025). Unveiling synergies: Integrating TCM herbal medicine and acupuncture with conventional approaches in stroke management. Neuroscience, 567(December 2024), 109–122. https://doi.org/10.1016/j.neuroscience.2024.12.043
  15. Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., MArthias, T., Harimurti, P., & Prawira, J. (2017). The Republic of Indonesia Health System Review. Health Systems in Transition, 7(1), 1–292. https://doi.org/WA 540.1
  16. McMahon, D., Dixon, D., Quinn, T., & Gallacher, K. I. (2024). The Acceptability of post-stroke cognitive testing through the lens of the theory of acceptability, a qualitative study. Cerebral Circulation - Cognition and Behavior, 6(100197), 1–7. https://doi.org/https://doi.org/10.1016/j.cccb.2023.100197
  17. Ministry of Health, R. of I. (2018). Curriculum and Capacity Building Model for Health Workers in Acupressure Services at Public Health Centers. Ministry of Health, Republic of Indonesia. https://ditmutunakes.id/portal-kemkes/detail-kurikulum-pelatihan/pelatihan-tenaga-kesehatan-dalam-pelayanan-akupresur-di-puskesmas/4d7a6b7a4e6a4d794d7a59744d7a557a4d6930304e7a4d304c5749794d7a4d744d7a497a4d7a4d794d7a417a4d444d77
  18. Ministry of Health, R. of I. (2022). ToT Module Curriculum for Capacity Building of Midwives in Toddler Massage Services for Child Growth and Development in Primary Health Care Facilities. https://ditmutunakes.id/portal-kemkes/detail-kurikulum-pelatihan/pelatihan-training-of-trainer-tot-peningkatan-kapasitas-bidan-dalam-pelayanan-pijat-baduta-untuk-tumbuh-kembang-anak-di-fasyankes/profil
  19. Ministry of Health, R. of I. (2023). Indonesian Health Survey 2023. Ministry Od Health, Republic Indonesia. https://drive.google.com/file/d/1NMZwTtFMamkmMe-H8OpZwan105kiSQtq/view
  20. Ministry of National Development Planning/Bappenas. (2022). White Paper. National Health System Reform. https://perpustakaan.bappenas.go.id/e-library/file_upload/koleksi/migrasi-data-publikasi/file/Policy_Paper/Buku Putih Reformasi SKN.pdf
  21. Moitra, P., & Madan, J. (2025). Stakeholder perspectives on integrating Ayurveda and Indian Indigenous Knowledge Systems into higher education: An exploratory study. Social Sciences and Humanities Open, 11(April), 101453. https://doi.org/10.1016/j.ssaho.2025.101453
  22. Mutola, S., Pemunta, N. V., & Ngo, N. V. (2021). Utilization of traditional medicine and its integration into the healthcare system in Qokolweni, South Africa; prospects for enhanced universal health coverage. Complementary Therapies in Clinical Practice, 43(December 2020), 101386. https://doi.org/10.1016/j.ctcp.2021.101386
  23. Negahban, A., Maleki, M., & Abbasian, A. (2018). Elements of integrating traditional and complementary medicine into primary healthcare: A systematic review. Journal of Clinical and Diagnostic Research, 12(12), IE05-IE11. https://doi.org/10.7860/JCDR/2018/36136.12417
  24. Ng, J. Y., Wieland, L. S., Lee, M. S., Liu, J. ping, Witt, C. M., Moher, D., & Cramer, H. (2024). Open science practices in traditional, complementary, and integrative medicine research: A path to enhanced transparency and collaboration. Integrative Medicine Research, 13(2), 101047. https://doi.org/10.1016/j.imr.2024.101047
  25. Nurlinawati, I., Mujiati, M., & Efendi, F. (2023). Factors influencing the retention of specialist doctors in the placement area: realist evaluation approach in the specialist doctor utilization program. Rural and Remote Health, 23(7610), 1–9. https://doi.org/10.22605/RRH7610
  26. Oktarina, O., & Rukmini, R. (2021). Implementation of Traditional Health Care Program Policy Surabaya City. Buletin Penelitian Kesehatan, 48(4), 291–300. https://doi.org/10.22435/bpk.v48i4.3584
  27. Park, Y. L., & Canaway, R. (2019). Integrating traditional and complementary medicine with national healthcare systems for universal health coverage in asia and the Western Pacific. Health Systems and Reform, 5(1), 24–31. https://doi.org/10.1080/23288604.2018.1539058
  28. Prasad, K., Prasad, A., Dyer, N. L., Bauer, B. A., Soderlind, J. N., Fischer, K. M., Croghan, I. T., Kaufman, C. C., Rosmarin, D. H., & Wahner-Roedler, D. L. (2025). Use of Complementary and Integrative Medicine Among Low-Income Persons With Mental Health Disorders. Mayo Clinic Proceedings: Innovations, Quality and Outcomes, 9(1), 100585. https://doi.org/10.1016/j.mayocpiqo.2024.11.002
  29. Ragunathan, M., & Abay, S. M. (2009). A survey on knowledge and attitude of pharmacy, health science and medical students towards traditional medicine as well as willingness of students and doctors towards the integration of traditional and modern medicine in Gondar university. Pharmacognosy Journal, 1(2), 146–153. https://www.scopus.com/inward/record.uri?eid=2-s2.0-77953460002&partnerID=40&md5=833ef6942d247115b284f1176b7cdf6c
  30. Rahayu, Y. Y. S., Araki, T., Rosleine, D., & Purwaningtyas, R. M. (2022). General Practitioners’ Attitudes toward Traditional Indonesian Herbal Medicine and Integrative Care in the Universal Health Coverage System. Global Journal of Health Science, 14(4), 82. https://doi.org/10.5539/gjhs.v14n4p82
  31. Sara, S. A. M., Heneka, N., Chambers, S. K., Dunn, J., & Terry, V. R. (2025). Acceptability of a nurse-led survivorship intervention for men with prostate cancer receiving androgen deprivation therapy: A qualitative exploratory study. European Journal of Oncology Nursing, 75(January), 102836. https://doi.org/10.1016/j.ejon.2025.102836
  32. Sebong, P. H., Pardosi, J., Goldman, R. E., Suryo, A. P., Susianto, I. A., & Meliala, A. (2024). Identifying Physician Public Health Competencies to Address Healthcare Needs in Underserved, Border, and Outer Island Areas of Indonesia: A Rapid Assessment. Teaching and Learning in Medicine, 1–12. https://doi.org/10.1080/10401334.2024.2353573
  33. Sekhon, M., Cartwright, M., & Francis, J. J. (2017). Acceptability of healthcare interventions: An overview of reviews and development of a theoretical framework. BMC Health Services Research, 17(1), 1–13. https://doi.org/10.1186/S12913-017-2031-8/TABLES/3
  34. Shirinabadi Farahani, A., Ashrafizadeh, H., Khoubbin Khoshnazar, T. A. S., Mehrnoush, N., Karami, M., Khademi, F., Eshaghian Dorcheh, A., Ebrahimloee, S., Koohi Rostamkalaee, Z., & Rassouli, M. (2023). Barriers to Applying Integrative Oncology from the Perspective of the Care Providers in Iran: A Mixed-Methods Study. Seminars in Oncology Nursing, 39(4), 1–10. https://doi.org/10.1016/j.soncn.2023.151444
  35. Situmorang, Y. (2018, December). Integrating Traditional Healthcare in Indonesia: Challenges and Recent Progress. Kemenkes RI. https://kesmas.ums.ac.id/wp-content/uploads/sites/49/2017/12/Materi-1-Dr.-Ina-Rosalina-Kemenkes-RI.pdf
  36. Sriatmi, A., Jati, S., & Rahmawati, A. (2016). Analysis of the Implementation of Integration of Traditional Health Services at Halmahera Health Centre, Semarang City. Jurnal Kesehatan Masyarakat (e-Journal), 4(1), 12–22
  37. Van Wietmarschen, H. A., Kapteijns, A., Busch, M., von Rosenstiel, I., Hoenders, R. H. J., & Baars, E. W. (2024). Setting a dutch integrative medicine research agenda: Results of a consensus-based strategy. European Journal of Integrative Medicine, 67(November 2023), 102353. https://doi.org/10.1016/j.eujim.2024.102353
  38. Walker, S., Ph, D., Robinson, L. J., Psy, D. C., Ph, D., Mhando, L., Psy, C., Paddick, S., Ph, D., & Psych, M. R. C. (2025). Feasibility and Acceptability Findings From a Pilot Study of the Adapted Ziba Ufa Intervention for Late Life Depression and Chronic Conditions in Tanzania. The American Journal of Geriatric Psychiatry: Open Science, Education, and Practice, 5(March), 21–33. https://doi.org/10.1016/j.osep.2024.11.001
  39. WHO. (2023). Integrating traditional and complementary medicine into health systems: social, economic and health considerations. WHO Technical Brief, June, 1–3. https://www.cbd.int/health/SOK-biodiversity-

Last update:

No citation recorded.

Last update: 2025-05-03 08:35:07

No citation recorded.