Integration of traditional and complementary medicine into primary health care systems: a systematic review

To explore the integration of traditional and complementary medicine in health systems and identify the enablers and barriers to the process.

We searched PubMed®, Embase, Web of Science, Latin American and Caribbean Health Sciences Literature, China National Knowledge Infrastructure and WanFang Database for original research on integration of traditional and complementary medicine in health systems published from 1 January 2001 to 27 January 2025. We focused on low- and middle-income countries. We made a thematic analysis to identify the enablers of and barriers to integration. We mapped factors according to the six blocks of health-care systems: service delivery; health governance and financing; medical products; health information systems; health workforce; and service standards.

We included 43 publications from 19 countries, with 55.8% (24/43) from countries in the African Region. Traditional and complementary medicine had the potential to strengthen various aspects of health systems, particularly in health-service delivery and products. We identified 11 determinant domains which could act as both an enabler of and barrier to integration. The most commonly mentioned determinants influencing integration of traditional and complementary medicine were policies and finance, resource availability, and efficacy, quality and safety.

Our findings highlight the role of policies and finance in supporting integration of traditional and complementary medicine, and the need to ensure the quality and safety of traditional products through scientific methods. Reforms in medical education and strategic resource allocation are needed to create the necessary conditions for successful integration of traditional and complementary medicine.