{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:07:13Z","timestamp":1790233633471,"version":"4.1.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Integrative and Complementary Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Regulatory frameworks for traditional and alternative medicine commonly emphasize licensure as a mechanism for ensuring safety, quality, and sustainability. However, limited evidence exists on whether licensure without ongoing oversight meaningfully regulates practitioner conduct or promotes sustainable practices. This study examined the relationship between licensure, regulatory supervision, compliance, and sustainability-related practices among traditional medicine practitioners (TMPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 303 TMPs. Data were collected on sociodemographic characteristics, licensing status, regulatory supervision, compliance with regulatory schemes, sources of raw materials, and cultivation practices. Associations were assessed using chi-square tests. The study is reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      While licensed practitioners were significantly more likely to report regulatory supervision than unlicensed practitioners (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 39.64,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), half of licensed practitioners had never experienced supervision. Overall compliance with regulatory schemes was low (12.2%) and was not significantly associated with perceived regulatory performance (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      = 0.53,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.465). Most practitioners relied on wild harvesting for raw materials (65.0%), with limited engagement in self-cultivation (17.2%) or intention to cultivate in the future (25.7%). Neither licensure nor supervision was significantly associated with adoption of cultivation practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The findings suggest that licensure without sustained supervision regulates entry into practice but does not effectively regulate conduct, compliance, or sustainability. Strengthening postlicensure oversight and integrating sustainability-focused regulatory mechanisms may be essential for achieving meaningful regulation of traditional medicine practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27683605261488964","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:57:14Z","timestamp":1789988234000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Licensure Without Oversight: Impact of Regulatory Supervision on Traditional Medicine Practice in Ghana"],"prefix":"10.1177","author":[{"given":"Benedict Owusu","family":"Yankyera","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Lincoln University College, Petaling Jaya, Malaysia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0647-3065","authenticated-orcid":false,"given":"Rudolph","family":"Mensah","sequence":"additional","affiliation":[{"name":"Traditional &amp; Alternative Medicine Directorate, Ministry of Health, Accra, Ghana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Busia","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lincoln University College, Petaling Jaya, Malaysia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_3_3_2_1","volume-title":"WHO global atlas of traditional, complementary and alternative medicine","author":"Bodeker G","year":"2014","unstructured":"1.Bodeker G, , Ong CK, , Grundy C, et al. WHO global atlas of traditional, complementary and alternative medicine. World Health Organization: Geneva; 2014."},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-013150"},{"key":"e_1_3_3_4_1","volume-title":"WHO traditional medicine strategy 2014\u20132023","author":"World Health Organization","year":"2013","unstructured":"3.World Health Organization. WHO traditional medicine strategy 2014\u20132023. WHO: Geneva; 2013."},{"key":"e_1_3_3_5_1","unstructured":"4.World Health Organization. WHO brings together Member States to strengthen quality and safety of traditional complementary and integrative medicine products. WHO: Geneva; 2025. Available from: https:\/\/www.who.int\/news\/item\/31-10-2025-who-brings-together-member-states-to-strengthen-quality-and-safety-of-traditional--complementary-and-integrative-medicine-products"},{"issue":"3","key":"e_1_3_3_6_1","first-page":"18","article-title":"Impact of traditional medicine integration with modern healthcare in Africa","volume":"5","author":"Kendi NN","year":"2024","unstructured":"5.Kendi NN. Impact of traditional medicine integration with modern healthcare in Africa. Newport Int J Sci Exp Sci 2024;5(3):18\u201321.","journal-title":"Newport Int J Sci Exp Sci"},{"key":"e_1_3_3_7_1","volume-title":"Guidelines for registration of traditional medicines in the WHO African Region","author":"World Health Organization","year":"2010","unstructured":"6.World Health Organization. Guidelines for registration of traditional medicines in the WHO African Region. WHO Regional Office for Africa: Brazzaville; 2010."},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-025-04812-2"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1475297"},{"key":"e_1_3_3_10_1","unstructured":"9.World Patients Alliance. WPA welcomes WHO\u2019s new global strategy on traditional medicine with a call for patient-centered integration. WPA: Geneva; 2025. Available from: https:\/\/www.worldpatientsalliance.org\/news\/wpa-welcomes-whos-new-global-strategy-on-traditional-medicine-with-a-call-for-patient-centered-integration\/"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biocon.2018.09.018"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5833945"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1903629"},{"issue":"1","key":"e_1_3_3_14_1","first-page":"88","article-title":"Public perceptions of traditional medicine in Ghana: Implications for integration and regulation","volume":"23","author":"Gyasi RM","year":"2016","unstructured":"13.Gyasi RM, , Mensah CM, , Adjei POW, , Agyemang S. Public perceptions of traditional medicine in Ghana: Implications for integration and regulation. Complement Ther Clin Pract 2016;23(1):88\u201393.","journal-title":"Complement Ther Clin Pract"},{"issue":"5","key":"e_1_3_3_15_1","first-page":"115","article-title":"Trends and challenges of traditional medicine in Africa","volume":"8","author":"Abdullahi AA","year":"2011","unstructured":"14.Abdullahi AA. Trends and challenges of traditional medicine in Africa. Afr J Tradit Complement Altern Med 2011;8(5 Suppl):115\u2013123.","journal-title":"Afr J Tradit Complement Altern Med"},{"issue":"3","key":"e_1_3_3_16_1","first-page":"27","article-title":"Medicinal plant cultivation and livelihoods: Lessons from India\u2019s conservation initiatives","volume":"40","author":"Rai R","year":"2020","unstructured":"15.Rai R, , Nautiyal BP, , Maikhuri RK. Medicinal plant cultivation and livelihoods: Lessons from India\u2019s conservation initiatives. Agron Sustain Dev 2020;40(3):27.","journal-title":"Agron Sustain Dev"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.indcrop.2011.01.019"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:BIOC.0000021333.23413.42"},{"key":"e_1_3_3_19_1","first-page":"109460","article-title":"Integrating medicinal plant cultivation in agroforestry systems for sustainability and resilience","volume":"142","author":"Sharma S","year":"2022","unstructured":"18.Sharma S, , Pandey R, , Bhattacharya P. Integrating medicinal plant cultivation in agroforestry systems for sustainability and resilience. Ecol Indic 2022;142:109460.","journal-title":"Ecol Indic"},{"key":"e_1_3_3_20_1","volume-title":"WHO guidelines on good agricultural and collection practices (GACP) for medicinal plants","author":"World Health Organization","year":"2003","unstructured":"19.World Health Organization. WHO guidelines on good agricultural and collection practices (GACP) for medicinal plants. WHO: Geneva; 2003."}],"container-title":["Journal of Integrative and Complementary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27683605261488964","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/27683605261488964","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/27683605261488964","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:46:23Z","timestamp":1790232383000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/27683605261488964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":19,"alternative-id":["10.1177\/27683605261488964"],"URL":"https:\/\/doi.org\/10.1177\/27683605261488964","relation":{},"ISSN":["2768-3605","2768-3613"],"issn-type":[{"value":"2768-3605","type":"print"},{"value":"2768-3613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"27683605261488964"}}