Complementary Therapies in Medicine (2009) 17, 292299

available at www.sciencedirect.com

journal homepage: www.elsevierhealth.com/journals/ctim

Use of traditional and complementary medicine

in Malaysia: a baseline study
Z.M. Siti a,, A. Tahir b, A. Ida Farah a, S.M. Ami Fazlin a, S. Sondi b,
A.H. Azman b, A.H. Maimunah b, M.A. Haniza b, M.D. Siti Haslinda b,
A.K. Zulkarnain b, I. Zakiah a, W.C. Wan Zaleha b

a
Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
b
Institute for Health System Research, Jalan Rumah Sakit Bangsar, 50590 Kuala Lumpur, Malaysia
Available online 6 November 2009

KEYWORDS Summary
Background: The increasing popularity and use of traditional and complementary medicine
Traditional;
(TCAM) in both developed and developing countries, including Malaysia, have raised signicant
Complementary;
public health policy issues. However, currently, there is a paucity of baseline data on such usage
Modalities;
by the Malaysian community.
Malaysia;
Objective: This study was conducted to identify and describe the prevalence and frequency of
Usage;
various TCAM modalities that are being used by the Malaysian population by age, gender, marital
Prevalence
and working status, educational level and ethnic group for health issues and maintenance.
Design: A nationwide interviewer-administered questionnaire survey was conducted in August
2004. An open-ended questionnaire pertaining to TCAM modalities was used to increase the
probability of capturing maximum data. This survey implemented a multistage design, stratied
by state and urban/rural random sampling, proportionate to the size of the state population
and was representative of the Malaysian population. Post-survey classication of modalities was
done accordingly. Complex data analysis was carried out using SPSS 13.0.
Results: Various TCAM modalities that were used by the Malaysian population were identi-
ed and categorised. Biological-based therapies, which included herbal therapy, were most
commonly used for health problems (88.9%) and for health maintenance (87.3%). Under this cat-
egory, herb-based application/herb-based beauty product/herb-based hygiene product group
was most commonly used for health issues (23.6%) while pure herbs were the ones most com-
monly used for health maintenance (29.6%). There was no signicant difference across all groups
in the usage of biological-based therapies for health issues.
Conclusion: The study showed that there is a high prevalence of TCAM use by the Malaysian
population, particularly in the use of herb-based therapies for both health issues and health
maintenance. Thus, a strict guideline for herbal commercialisation as well as public education
is important.
2009 Elsevier Ltd. All rights reserved.

Corresponding author at: Cancer Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
E-mail address: sitizuraidah@rocketmail.com (Z.M. Siti).

0965-2299/$ see front matter 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ctim.2009.04.002
Use of traditional and complementary medicine in Malaysia 293

Introduction practitioners such as bomoh (Malay traditional prac-

titionerMalay shaman), singseh (traditional Chinese
Traditional medicine has been dened by the World Health practitioner), ayurvedic practitioners, unani practition-
Organization (WHO) as: a sum total of the knowledge, skills ers, masseuse/masseur, acupuncturist, reexologist,
and practices based on the theories, beliefs and experiences homoeopathist, spiritual healer and others; or
indigenous to different cultures, whether explicable or not, A person could also administer by himself/herself without
used in the maintenance of health as well as prevention, consulting a traditional/complementary medicine prac-
diagnosis, improvement or treatment of physical and mental titioner, therapies such as traditional medicine/herbs,
illness.1 Chinese medicines, the practice of yoga, Qi Qong, reex-
WHO has also reported that about two-thirds and 5080% ology and others.
of the population of developed and developing coun-
tries, used traditional and complementary medicine (TCAM), To familiarise respondents with examples of traditional
respectively. WHO has also recognised the important role medicine practices, a modality card containing photos of
of TCAM in the prevention and promotion of health for a examples of traditional/complementary practices was also
large proportion of the population, especially in developing shown to respondents.
countries, and advocates tapping its usefulness.1
Bhakaji and Paneerazakathu reported in the Regional
Sampling
Overview: South East Asia Region, apart from Bangladesh
and Indonesia, no other countries have undertaken surveys
The survey covered all the states of Malaysia. The sam-
on the utilization and practices of TCAM despite being prac-
ples consisted of those residing in non-institutional living
tised in all South East Asia Region, for many centuries,
quarters for more than 6 months. The sampling was multi-
indeed millennia.2
staged and stratied by state and urban/rural areas. It was
The Malaysias National Health and Morbidity Survey II,
a based on the random sampling method, proportionate to
which was conducted in 1996, had reported that 2.3% of
state population size and representative of the Malaysian
the population visited TCAM practitioners and 3.8% visited
population by age, gender and ethnicity (refer Figs. 13).
both modern and TCAM practitioners. However, this nding
was very much lower than the WHO estimate. This could be
because the questionnaire formulated for the study was not
proposed to capture the real estimate of TCAM usage by the Table 1 Categorization of modalities, e.g., of sub-group.
Malaysian population.
Therefore, this study was conducted to determine the 1. Mind-body medicine Meditation
prevalence and types of TCAM modalities used by the Hypnosis
Malaysian population. Prayers for health reason
Exercise, dance and leisure,
e.g., yoga, chi qong
Objective Energy healing therapies, e.g.,
magnetic healing
The research was conducted to describe the prevalence and 2. Biologically based Herbs
frequency of various TCAM modalities that are being used by therapies
the Malaysian population stratied by age, gender, marital Vitamin and supplement
and working status, educational level and ethnic group for Animal parts
health issues and health maintenance. Application/beauty/hygiene
product
Methodology Diet based therapy, e.g.,
nutrition therapy
This survey conducted by the Ministry of Health, Malaysia, 3. Manipulative and Midwifery
used interviewer-administered questionnaires. This survey body based practices
was conducted mainly in Malay language and supplemented Bekam/cupping
by English/Tamil/Chinese translation whenever necessary. Massage
For this survey, one or more of the following denitions Bone therapy, e.g., rawatan
of TCAM were applied: patah tulang
Reexology
The medical beliefs and practices for health care and Temperature based, e.g.,
treatment practised by all races. It might be passed down demah
from generation to generation. It included homeopathy, Rawatan resdung
cupping (bekam), reexology, Qi Qong and others; or 4. Whole medical Acupuncture
The therapies that did not include treatment and systems
medicines from hospitals or health clinics (conven- Ayurveda
tional/orthodox medicine); or Homeopathy
Therapies/practices obtained by seeing/visiting/ Traditional Chinese medicine
consulting a traditional/complementary therapists/
294 Z.M. Siti et al.

What was the name of the modality of TCAM used?

Table 2 10 most commonly reported specic modalities
What was done or used?
used for health problem.
On which part of the body was it applied?
Subcategory (modality) Percentage of usage For what reason was the modality used?
(health problem)
These questions were structured to comprehensively cap-
Herbs based 23.6%
ture relevant information that was as accurate as possible
application/beauty/herb based
to describe the type of modality administered. This was
hygiene product
regarded necessary as not every respondent would know the
Herbs 17.10%
exact name, method or terminology of the modality admin-
Resdung treatment 10.0%
istered.
Homeopathy 10.0%
Answers in Chinese, Tamil and indigenous languages,
Temperature based (hot or cold 10.0%
that is, Kadasan Dusun languages, were translated into the
water application)
Malay language. Each answer was given specic codes for
Acupuncture 10.0%
the creation of a master list, which became the reference
Massage 4.9%
for classication and analysis. These codes were then sub-
Animal based therapy (e.g., birds 4.20%
grouped and these were later categorised into four main
nest)
sections.
Prayer for health reason 2.30%
We also found that some of the respondents answers,
Midwifery 1.0%
for example, paracetamol, fell under the category of
conventional medication instead of traditional or comple-
mentary therapy. Such answers were coded as non-TCAM and
This was based on the projected population for Malaysia for excluded from the analysis.
2004 based on the National Census of 2000.

Data management and analysis

Data collection
Double data entry was carried out manually using SQL server
Data were collected in August 2004 by trained survey team and converted into SPSS database. Data cleaning and com-
members from local health ofces. Their training included plex data analysis were conducted with SPSS Version 13.
methods of asking the questions, providing appropriate Data were rst weighted for the probability of selection
explanation on the types of TCAM modalities available and in the sampling procedure, then weighted to adjust for
documenting the answers based on structured questions. geographic variation in response (by state and urban/rural
location) and post-stratication to population distribution
Post-survey classication (by age, sex and urban/rural location) based on the pro-
jected population for Malaysia for 2004, based on the
All sections containing the answers describing the types of National Census of 2000.
treatment for health issues and health maintenance were
reviewed, assessed and coded. For these sections, four stan- Results
dardised open-ended questions were asked:
There were 6947 respondents for this survey. The analysis
showed that this sample was representative of the Malaysian
Table 3 10 most commonly reported specic modalities population (Figs. 13). The response rate was 81% of those
used for health maintenance. residing in non-institutional living quarters. The prevalence
Subcategory (modality) Percentage of usage of ever-used TCAM in their lifetime was 69.4% (67.671.2%)
(health maintenance) and in the last 12-month period was 55.6% (53.857.4%).3
The various TCAM modalities used by the Malaysian com-
Herbs 29.6% munity are recorded in Table 1. The result showed that
Exercise, dance and leisure for 11.0% there was a vast range of modalities used, including a long
health reason (body movement) list of pure and mixed herbs, animals, spiritual therapies
Vitamin and supplement 7.40% including incantation, manual techniques and exercises.
Herbs based 6.30% These modalities were further subgrouped and categorised
application/beauty/herb based into four main categories according to the National Cen-
hygiene product ter for Complementary and Alternative Medicine (NCCAM)
Animal based therapy (e.g., birds 3.80% classication.4
nest)
Diet based therapy 1.7%
Midwifery 1.7% Prevalence of modalities used for health problem
Prayer for health reason 1.4%
Massage 1.10% Fig. 4 shows that biological-based therapies (88.9%) were
Reexology 0.4% the main resource used for health issues while whole medi-
cal system was the least used (1.9%). Other categories used
Use of traditional and complementary medicine in Malaysia
Figure 1 Malaysian population by age and region in 2000 (gure in 000).
Institute of Health System Research, 2008.
Figure 2 Malaysian population by gender and region by 2000
(gure in 000).
Institute of Health System Research, 2008.
were manipulative and body-based (27.0%) and mind body
medicine (11.1%).
Under the category of biological-based therapies, herb-
based application/herb-based beauty product/herb-based
hygiene product group had the highest population estimate
of use, with pure herbs as the second-most commonly used
Figure 3 Malaysian population by ethnicity and region by 2000 (number in 000).
Institute of Health System Research, 2008.
295
therapy. Majority of the biological-based therapies were
made up of herb-based medicine either in individual or
mixed forms. The mixtures were used either in combination
with other herbs or honey or animal parts.
Under the category of manipulative and body-based
medicines, the four most common modalities used were
sinusitis treatment (10.0%), temperature based (hot or cold
water application) therapies (10.0%), massage (4.9%) and
midwifery (1.0%).
Under the category of mind body medicine, prayer for
health reasons (2.3%) was most oftenly used for health issues
(Refer Table 2).
Under the category of whole medical system, acupunc-
ture (0.1%), homeopathy (0.1%) and traditional Chinese
medicine (0.1%) were commonly used.
Prevalence of modalities used for health
maintenance
Fig. 5 demonstrates that 87.3% of responses used biological-
based therapies for health maintenance, followed by mind
296
Figure 4 Prevalence of modalities used by Malaysian popula-
tion for health problem.
Figure 5 Prevalence of modalities used by Malaysian popula-
tion for maintaining health.
body medicine (41.0%) and manipulative and body-based
(26.4%) medicines, while whole medical system was the
least to be used (1.5%).
Under the category of biological-based therapies, pure
herb has the highest population estimate of use (29.6%) fol-
lowed by vitamin and supplement (7.4%) with herb-based
application/herb-based beauty product/herb-based hygiene
product group being the third most commonly used (6.3%)
therapy (Refer Table 3).
Under the category of mind body medicine, exercise,
dance and leisure for health reason (body movement, i.e.,
Tai chi) was commonly used (11.0%) followed by prayer for
health reasons (1.4%).
Under the category of manipulative and body based ther-
apy, the most common modalities being used were midwifery
(1.7%), massage (1.1%) and reexology (0.4%).
Prevalence of different TCAM modality categories
used for health issues by age, sex, marital and
working status, educational level and ethnic group
Table 4 shows the prevalence in different age, sex, marital
and working status, educational level and ethnic groups in
using four different categories of TCAM modalities for health
issues.
Mind body medicine
The users of this therapy were from the group of extreme
age range (09 and 80 years and above), female (11.2%)
slightly higher than the male (10.9%) and the single marital
status group used this therapy more than the other groups.
The category of no formal schooling had the highest preva-
lence of usage (14.3%) although not statistically different
Z.M. Siti et al.
from other educational level groups. The not-working group
also had the highest prevalence of usage (15.8%). The
Malay group (13.1%), Bumiputra Sabah (11.4%), Bumiputra
Sarawak (11.0%) and Orang Asli (11.7%)all reported
signicantly higher percentages of use compared with the
Chinese (5.1%).
Biological-based therapies
This therapy had the highest prevalence by all characteris-
tics. It was used by more than 90% of the 5059, 6069 and
80 years and above age groups. It was also highly used by
women (89.8%). The divorcee/widow/widower (91.5%), no
formal schooling (91.5%) and housewife (91.5%) groups had
the highest number of users. More than 90% of the users were
Chinese (92.4%), Indians (92.0%), Bumiputra Sabah (97.3%)
and Bumiputra Sarawak (91.2%).
Manipulative and body based
More than a quarter of the population of 2029, 3039,
4049, 5059, 6069 and 7079 years age groups
used this therapy. The female group had a slightly
higher use (27.3%) but this was not signicantly dif-
ferent from that of the male group. The married and
divorcee/widow/widower group had the highest preva-
lence within the group (31.7%). Within the educational
level, the college/university group had the highest preva-
lence by 30.5%. More than a quarter of the users were
housewives (31.8%), government servants (36.0%) and self-
employed (31.1%). The ethnic group of Orang Asli were
signicantly the highest users (64.9%) compared with other
ethnic groups.
Whole medical system
The highest prevalence in the age groups using this ther-
apy was the age group of 5059 (4.2%) and 7079 years
(5.6%). The male group showed higher usage (2.1%) com-
pared with females (1.7%). The divorcee/widow/widower
group showed highest prevalence of usage among the mari-
tal status group (3.3%). The college/university group showed
4.6% of usage in the educational group. Self-employed (3.3%)
and pensioners (3.0%) showed the highest prevalence within
the job category. In the ethnic category, the Chinese (6.6%)
showed the highest prevalence of usage followed by Indian
(2.8%).
Prevalence of use of traditional and
complementary medicine for health maintenance
by age, sex, marital and working status,
educational level and ethnic group
Table 5 shows the prevalence in different age, sex, marital
and working status, educational level and ethnic groups in
the use of the four different categories of TCAM modalities
for health maintenance.
Mind body medicine
The characteristics of users for this therapy were of age
1019 years (58.8%) and 6069 years (44.6%); male (46.1%)
slightly higher than the female (35.9%); cohabit group (100%)
used more than the other group. Regarding educational lev-
Use of traditional and complementary medicine in Malaysia 297

els, the upper secondary reported the highest prevalence of
usage (48.2%) even though not statistically different from
other educational level groups. More than half of the respon-
dents from the schooling and pensioner group also used this
therapy.
Biological-based therapies
This therapy had the highest prevalence within all groups. It
was used by more than 80% of all age groups except 80 years
and above. It was used slightly more by the female group
(87.5%). All of those cohabiting (100%) used this method of
therapy, while the other marital status used to an extent
of more than 80%. More than 85% of the population from
all educational levels used this therapy. More than 85% of
the population from the working status category used this
modality. More than 80% of the population from all ethnic
groups used this therapy, the highest being the Orang Asli
(93.2%).
Manipulative and body based
Approximately, more than a quarter of the age 20 and
above group used this therapy. The female group showed
signicantly higher prevalence, 37.2% (95% CI, 34.739.8)
than the male group, 12.4% (10.614.5). Almost 50%
of the divorcee/widow/widower group used this mode
of therapy. Within the educational level group, more
than 25% of all groups populations had used this ther-
apy. The housewife group reported signicantly higher
prevalence of use (49.7%, 95% CI, 45.753.8) than the
rest of the working status category. The Malay group
showed the highest prevalence by 32.4% although not
statistically different from the Orang Asli population
(27.3%).
Whole medical system
Only 1.7% of the ethnic Malay and 1.8% of Chinese used this
mode of therapy. Less than 5% of all age, sex, marital status,

Table 4 Prevalence of use of T/CM modalities category by age, sex, marital and working status, education level and ethnic
group for health problem.

Characteristic Mind body Biologically based Manipulative and Whole medical

medicine (95% CI) therapies (95% CI) body based (95% CI) system (95% CI)

09 15.3%(12.3,19.0) 87.6%(84.2,90.3) 21.7%(18.3,25.6) 0.6%(0.3,1.5)

1019 11.5%(9.2,14.2) 89.2%(86.591.4) 20.9%(17.7,24.4) 0.6%(0.2,1.8)
2029 10.0%(7.8,12.7) 86.8%(83.7,89.3) 28.3%(24.5,32.5) 1.7%(1.0,3.2)
3039 8.7%(6.5,11.4) 89.4%(86.4,91.8) 34.6%(30.7,38.8) 1.9%(1.1,3.5)
Age 4049 10.5%(8.3,13.4) 89.0%(86.1,91.4) 30.1%(26.2,34.4) 2.8%(1.7,4.5)
5059 9.0%(6.4,12.5) 92.1%(88.9,94.5) 25.8%(21.4,30.8) 4.2%(2.6,6.7)
6069 11.4%(7.9,16.2) 92.4%(88.6,95.0) 28.3%(22.7,34.7) 1.9%(0.8,4.4)
7079 8.4%(4.4,15.5) 83.5%(74.4,89.7) 30.9%(22.5,40.8) 5.6%(2.5,11.9)
80 and above 22.0%(15.5,38.6) 95.1%(82.0,98.8) 22.9%(12.1,39.2) 2.8%(0.4,17.7)
Male 10.9%(9.4,12.6) 88.0%(86.4,89.5) 26.6%(24.5,28.9) 2.1%(1.5,3.0)
Sex
Female 11.2%(9.7,12.9) 89.8%(88.2,91.1) 27.3%(25.3,29.4) 1.7%(1.2,2.4)
Single 12.7%(10.9,14.7) 87.7%(85.8,89.3) 22.7%(20.4,25.1) 1.3%(0.8,2.0)
Married 9.5%(8.2,11.0) 89.9%(88.2,91.1) 30.8%(28.5,33.1) 2.4%(1.8,3.2)
Marital status
Divorcee/widow/widower 12.0%(8.2,17.1) 91.5%(86.8,94.6) 31.7%(25.5,38.5) 3.3%(1.5,7.0)
Cohabit 78.0%(24.1,97.5) 22.0%(2.5,75.9)
No formal schooling 14.3%(11.4,17.8) 91.5%(88.9,93.6) 25.5%(21.9,29.4) 2.0%(1.1,3.6)
Primary 10.5%(8.7,12.5) 89.4%(87.2,91.2) 26.4%(23.6,29.4) 1.8%(1.1,2.8)
Education level Lower secondary 10.7%(8.6,13.4) 86.8%(84.1,89.0) 27.4%(24.0,31.0) 1.5%(0.8,2.6)
Upper secondary 8.5%(6.7,10.6) 89.7%(87.4,91.7) 28.7%(25.6,32.0) 1.8%(1.1,2.9)
College/university 10.4%(7.4,14.4) 86.9%(82.1,90.6) 30.5%(25.3,36.3) 4.6%(2.7,7.6)
Housewife 9.7%(7.7,12.3) 91.5%(88.6,93.0) 31.8%(28.3,35.5) 1.9%(1.1,3.3)
Schooling 12.0%(9.8,14.6) 89.4%(86.9,91.5) 21.7%(18.5,25.3) 0.8%(0.4,1.8)
Government 8.1%(5.2,12.3) 90.0%(85.4,93.3) 36.0%(30.0,42.4) 1.9%(0.8,4.4)
Working status Private 9.1%(7.3,11.4) 88.1%(85.6,90.2) 27.3%(24.2,30.7) 2.4%(1.6,3.7)
Self employment 10.4%(8.1,13.3) 89.0%(86.0,91.5) 31.1%(27.2,35.2) 3.3%(2.0,5.2)
Pensioner 14.7%(8.9,23.3) 85.8%(76.6,91.7) 21.1%(13.1,31.6) 3.0%(1.0,9.0)
Not working/schooling 15.8%(11.4,21.5) 88.5%(84.1,91.8) 22.4%(17.8,27.9) 1.4%(0.5,3.6)
Malay 13.1%(11.5,14.8) 86.4%(84.8,87.9) 31.0%(28.9,33.3) 0.8%(0.5,1.2)
Chinese 5.1%(3.1,8.2) 92.4%(89.9,94.4) 15.7%(12.9,19.1) 6.6%(4.9,8.8)
Indian 5.9%(2.8,12.2) 92.0%(87.1,95.1) 18.6%(13.5,24.9) 2.8%(0.8,10.0)
Ethnic group
Bumiputra Sabah 11.4%(7.7,16.7) 97.3%(94.3,98.7) 28.2%(21.6,35.8) 1.1%(0.3,3.2)
Bumiputra Sarawak 11.0%(7.0,16.8) 91.2%(86.3,94.5) 22.9%(17.8,29.0) 0.8%(0.2,3.3)
Orang Asli 11.7%(7.1,18.6) 76.4%(56.1,89.2) 64.9%(38.2,84.7) 0.6%(0.1,3.9)
298 Z.M. Siti et al.

educational level and working status groups have used this
method of therapy for health issues.
Discussion and conclusion
This study provided the baseline information for usage
of various traditional and complementary therapies in
Malaysia at the nationwide level. In summary, the preva-
lence of TCAM usage is within WHO estimation (5080%)
and is lower than that in the study conducted in Sin-
gapore (76%)5 and Japan (76%).6 This result might also
reect the overall prevalence of TCAM usage in Southeast
Asia.
The vast range of modalities was a manifestation of
ethnic and cultural diversity of the Malaysian population.7
Certain modalities practiced may only represent a minor ele-
ment of the healing process but a key element in the ethnics
culture.8
The dominant use of herbs in a variety of ways was natu-
rally due to the fact that Malaysia is diverse in ethnicity that
still follows generations of traditional healing practices sup-
ported by vast natural resources. This corroborated previous
ndings by Tindle et al.9 and Tan et al.10
The preliminary idea of using a pre-coded modalities
list proved to be non-representative due to the presence of
different varieties of traditional and complementary modal-
ities compared with Western and Japanese surveys.4,11,12
However, this issue was resolved by means of open-ended
qualitative questionnaires,13,14 which managed to capture a
comprehensive list of traditional and complementary modal-
ities used by the Malaysian population. The post-survey

Table 5 Prevalence of use of traditional and complementary medicine by age, sex, marital and working status, education level
and ethnic group for health maintenance.

Characteristic Mind body Biologically based Manipulative and Whole medical

medicine (95% CI) therapies (95% CI) body based (95% CI) system (95% CI)

09 31.7%(24.639.7) 89.9%(86.592.6) 11.9%(8.616.4) 3.0%(1.46.4)

1019 58.8%(53.164.3) 80.5%(76.584.0) 11.5%(8.315.7) 1.5%(0.54.5)
2029 39.4%(33.645.6) 89.2%(86.391.5) 29.1%(25.033.5) 1.2%(0.53.0)
3039 39.4%(33.845.3) 85.6%(82.588.2) 34.3%(30.538.4) .6%(0.83.5)
Age 4049 31.7%(26.137.9) 92.4%(89.894.4) 37.5%(33.242.0) 1.1%(0.42.7
5059 39.1%(32.246.5) 88.8%(84.991.8) 9.4%(24.434.9) 0.6%(0.12.3)
6069 44.6%(35.753.9) 83.1%(76.788.0) 26.0%(20.032.9) 1.6%(0.54.8)
7079 31.6%(20.545.3) 83.1%(83.996.1) 24.4%(15.835.7) 2.6%(0.69.7)
80 and above 39.8%(19.464.4) 75.9%(55.688.8) 41.6%(24.161.5)
Male 46.1%(42.549.8) 87.1%(85.188.8) 12.4%(10.614.5) 1.8%(1.12.8)
Sex
Female 35.9%(32.639.4) 87.5%(85.889.0) 37.2%(34.739.8) 1.4%(0.92.2)
Single 45.7%(41.550.0) 86.5%(84.288.4) 12.9%(10.715.4) 1.8%(1.03.1)
Married 38.1%(34.741.5) 88.0%(86.389.5) 33.7%(31.536.1) 1.4%(0.92.2)
Marital status
Divorcee/widow/ 29.9%(21.839.6) 88.8%(82.493.1) 48.1%(40.455.8)
widower
Cohabit 100% 100%
No formal schooling 35.3%(28.842.5) 87.5%(83.390.8) 23.9%(19.429.2) 1.3%(0.62.8)
Primary 39.5%(34.944.3) 85.8%(83.388.0) 25.9%(22.829.3) 0.7%(0.31.8)
Education level Lower secondary 41.8%(36.647.2) 86.3%(85.490.7) 28.8%(25.132.8) 1.4%(0.53.6)
Upper secondary 48.2%(43.253.2) 85.8%(83.388.0) 28.7%(25.432.2) 1.2%(0.62.3)
College/university 44.9%(37.452.6) 89.7%(85.892.7) 28.0%(22.534.3) 3.1%(1.46.9)
Housewife 30.8%(25.836.4) 87.2%(84.189.7) 49.7%(45.753.8) 1.1%(0.52.4)
Schooling 53.4%(47.559.3) 83.2%(79.486.4) 9.4%(6.613.2) 1.4%(0.53.8)
Government 40.9%(33.149.1) 86.8%(81.990.5) 35.7%(29.842.0) 2.8%(1.26.6)
Working status Private 41.4%(36.146.8) 89.9%(87.691.8) 21.5%(18.424.9) 1.0%(0.42.2)
Self employment 38.5%(32.944.4) 88.4%(85.191.0) 27.9%(23.932.3) 1.3%(0.62.8)
Pensioner 57.4%(43.770.1) 85.7%(76.091.9) 16.4%(8.928.4) 1.3%(0.28.7)
Not working/ 39.2%(29.749.6) 85.0%(79.089.4) 18.0%(12.325.5) 1.3%(0.34.1)
schooling
Malay 38.6%(35.441.9) 84.5%(82.686.2) 32.4%(30.134.8) 1.7%(1.02.7)
Chinese 51.8%(44.459.1) 92.4%(89.394.7) 10.9%(7.914.9) 1.8%(0.83.6)
Indian 58.8%(48.768.3) 89.5%(84.594.7) 18.1%(12.824.9) 0.5%(0.13.4)
Ethnic group
Bumiputra Sabah 35.9%(24.648.9) 89.7%(83.393.8) 21.0%(15.327.9) 1.7%(0.46.7)
Bumiputra Sarawak 26.0%(15.939.5) 86.7%(79.191.8) 25.0%(17.234.9) 1.6%(0.46.0)
Orang Asli 42.3%(26.459.9) 93.2%(88.496.1) 27.3%(19.237.2)
Use of traditional and complementary medicine in Malaysia
identication and classication of the type of modalities
used provided the necessary research tool for future studies
in a related topic.
There are several limitations in the current study. Our
result showed that there was a very low usage for the
whole medical system, for example, the traditional Chinese
medicine, ayurveda and homeopathy. This could be because
many respondents described the modalities involved instead
of the practice of the healer that they visited. For example,
the respondent might have consulted a traditional Chi-
nese medicine practitioner who prescribed a Chinese herb.
Instead of reporting that she consulted a traditional Chi-
nese medicine practitioner, she might have reported that she
had received the herb; thus, these data were recorded and
analysed as herbal therapy and not as traditional Chinese
medicine.
In conclusion, a high usage of herbs by the Malaysian
population needs to be supported by extensive scien-
tic research to gain optimum use without suffering side
effects.15 Thus, strict regulation for the registration of com-
mercialised herbs is advised and also that public education
is pertinent.16,17
Acknowledgements
We would like to acknowledge the Director of The Insti-
tute for Medical Research, all state health directors and all
the eld data collection teams who gave their full commit-
ment during the survey process. This project was funded by
Ministry of Health, Malaysia.
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Glossary
Living quarters: A living unit, structurally separate (surrounded by
walls, fences, etc., and covered by a roof), independent (has
direct access through a public staircase, communal passages or
landing) and meant for living.
Mind body medicine (Ref: http://nccam.nih.gov/health/
whatiscam/): Mind body medicine focusses on the inter-
actions among the brain, mind, body and behaviour and the
powerful ways in which emotional, mental, social, spiritual and
behavioural factors can directly affect health.
Biologically based therapies (Ref: http://nccam.nih.gov/health/
whatiscam/): The domain of biologically based practices
includes, but is not limited to, botanicals, animal-derived
extracts, vitamins, minerals, fatty acids, amino acids, proteins,
prebiotics and probiotics, whole diets, and functional foods and
combinations.
Dietary supplements are a subset of this domain: In the Dietary
Supplement Health and Education Act (DSHEA) of 1994,17 the
US Congress dened a dietary supplement as a product taken by
mouth that contains a dietary ingredient intended to supplement
the diet. The dietary ingredients in these products may include
vitamins, minerals, herbs or other botanicals, amino acids, and
substances such as enzymes, organ tissues, glandular organs and
metabolites. Dietary supplements can also be extracts or con-
centrates, and they can occur in many forms, such as tablets,
capsules, soft gels, gel caps, liquids or powders.
Manipulative and body based therapies (Ref: http://nccam.nih.
gov/health/whatiscam/): Manipulative and body-based prac-
tices focus primarily on the structures and systems of the body,
including the bones and joints, the soft tissues and the circula-
tory and lymphatic systems.
Whole medical system (Ref: http://nccam.nih.gov/health/
whatiscam/): Whole medical systems involve complete systems
of theory and practice that have evolved independently from
or are parallel to allopathic (conventional) medicine. Many of
these are traditional systems of medicine that are practiced by
individual cultures throughout the world.
Bumiputra Sabah (Ref: http://www.sabah.org.my/bm/kenali
sabah/penduduk sabah.asp): They are the indigenous com-
munity of Sabah. The largest ethnic group in Sabah are
Kadazandusun, Kadazan, Bajau and Murut.
BumiputraSarawak (Ref: http://www.idesa.net.my/modules/
news/article.php?storyid=297): They are the indigenous com-
munity of Sarawak. There are more than 29 minority groups and
among these are Iban, Melanau, Bidayuh, Penan, Orang Dusun
and Orang Ulu.