Palestinian consumers’ perspectives on integrating traditional, folk, and home remedies with conventional medicine for illness prevention and management in the northern West Bank

Abstract

Traditional, folk, and home remedies (TFHR) are deeply embedded in Palestinian culture and healthcare-seeking behavior, shaped by centuries of historical occupation, limited healthcare access, and rich ethnomedical heritage. Despite their widespread use, there remains a scarcity of qualitative, community-level research documenting the perceptions, attitudes, and practices surrounding TFHR in Palestine. This study aimed to explore and document the perceptions, attitudes, and practices related to traditional, folk, and home remedies among adults in the northern West Bank, Palestine, and to examine how these are integrated with conventional medicine in the prevention and management of illness and disease. A qualitative descriptive design employing directed qualitative content analysis, following the approach described by Hsieh and Shannon, was used. Face-to-face, semi-structured interviews were conducted with 35 community-dwelling adults recruited from Nablus Governorate in the northern West Bank, Palestine, including Nablus city, the surrounding villages of Beit Dajan, Salem, and Asira al-Shamaliya, and the Balata and Askar refugee camps. Participants were recruited using purposive and snowball sampling. Data collection continued until thematic saturation was achieved, defined as the point at which no new themes emerged from the data and confirmed through three additional interviews. Data were managed and coded using MAXQDA 2022. Directed qualitative content analysis was then performed, leading to the identification of three overarching themes and multiple subcategories. Three overarching themes emerged: (1) Knowledge and Practices of TFHR, encompassing types and methods used and sources of knowledge; (2) Attitudes toward TFHR, including perceived usefulness, consultation with healthcare professionals, advice and recommendations to others, and perception of safety; and (3) Use and Application of TFHR, covering determinants of use, prioritization and integration with modern medicine, and indications of use. The predominant pattern across all settings was the intergenerational transmission of TFHR knowledge through family networks, with grandmothers and mothers identified as primary knowledge holders. Herbal medicines (Za’atar, sage, black seed, olive oil), dietary therapies, and spiritual/religious practices were most commonly used. Attitudes ranged from strong belief in TFHR effectiveness to cautious acceptance, with safety concerns particularly heightened for pregnant women and children. Economic barriers, dissatisfaction with conventional care, limited healthcare access due to movement restrictions, and cultural identity emerged as key drivers of use. Regarding integration with conventional medicine, participants described three patterns: using TFHR as a first-line treatment before seeking biomedical care for mild symptoms, using TFHR alongside prescribed medications without informing providers, and, less commonly, discussing TFHR use with providers to obtain guidance on safe integration; most participants did not disclose their TFHR use to healthcare professionals. Healthcare providers should routinely inquire about TFHR use, recognize these culturally embedded practices, and engage patients in culturally sensitive discussions to minimize herb–drug interactions and other potential risks. Further research is needed to evaluate the safety, feasibility, and appropriate regulatory and educational strategies for integrating TFHR into Palestinian healthcare services.