Traditionally used medicinal plants for human ailments and their threats in Guraferda District, Benchi-Sheko zone, Southwest Ethiopia

Abstract

Background

The field of traditional medicine encompasses a wide range of knowledge, skills, and practices that are deeply rooted in the theories, beliefs, and experiences of different cultures. The research aimed to identify traditional medicinal plants used in Guraferda District and assess the threats they face.

Method

A total of 96 individuals, 80 males and 16 females, were interviewed to gather ethnobotanical data. Statistical tests like independent t tests, ANOVA, correlation, and regression were conducted using R software version 4.3.2 to compare informant groups.

Result

The study found 81 medicinal plant species in the district from 71 genera and 38 families, with Asteraceae and Solanaceae families having the most species. Leaves were the most commonly used plant part for medicine. Significant differences in plant knowledge were observed across genders, age groups, education levels, and experiences. The highest ICF value was for Dermal and Cutaneous ailments, and Cissampelos mucronata A. Rich and Bidens pilosa L. had the highest fidelity levels.

Conclusion

The study highlighted the importance of traditional medicinal plants in treating ailments but noted threats like overharvesting, habitat destruction, and climate change. Conservation efforts and sustainable harvesting practices are crucial to ensure the availability of these plants for future generations. Further research is needed to explore their potential for modern medicine and develop sustainable use strategies.

Background

Traditional medicine encompasses a wide range of knowledge, skills, and practices that are based on the theories, beliefs, and experiences of diverse cultures [1]. Traditional medicinal plants have been a fundamental part of healthcare systems in many societies worldwide, with a history that may span over 4000 years, as noted by [2, 3]. Medicinal plants serve as the primary source of healthcare for around 80% of the population in developing countries globally [4, 5]. In Africa, plants have played a crucial role in treating a wide range of human ailments within indigenous communities, including traditional healers and herbalists [6, 7].

In Ethiopia, traditional herbal remedies have been utilized for generations to address a variety of human health issues. This practice is rooted in cultural acceptance, affordability, cost-effectiveness, and accessibility. In many regions where modern healthcare services are scarce, rural communities heavily depend on traditional medicine as their main form of healthcare. The transmission of traditional knowledge typically occurs orally, with practitioners playing a vital role in passing down this valuable medicinal wisdom [8]. It is estimated that the country is home to a diverse array of approximately 6000 to 7000 higher plant species, with around 12% of these species being unique to the region. Over 800 plant species are utilized in Ethiopia for treating diverse ailments. TMPs use is common in both rural and urban areas, with people seeking these remedies alongside modern healthcare. Nearly 80% of the Ethiopian population depends on home remedies, and a significant majority of about 95% is derived from botanical sources [9].

The southwest forests of Ethiopia boast rich plant diversity, with 63% of the region's dense forests dedicated to preserving medicinal plants out of the country's 7000 species. These plants play a vital role in traditional medicine, addressing various health concerns in humans, as noted by [2, 10]. However, the extensive knowledge of medicinal plants is under severe threat due to deforestation, environmental degradation, and population growth. These factors are endangering the country's forests, which are a crucial source of medicinal plants, leading to the loss of traditional knowledge.

Similar to other regions in Ethiopia, the inhabitants of Guraferda District have their own traditional methods for self-care. Moreover, the ecological makeup of Guraferda District encompasses highlands, midlands, and lowlands. Given this diverse ecological landscape, it is expected that the variety and traditional uses of medicinal plant species are more pronounced in this area.

The Guraferda District is encountering challenges to its traditional medicinal plants and indigenous knowledge, including expansion of agriculture, excessive harvesting, deforestation, modernization, and the introduction of invasive alien species. Therefore, conducting a comprehensive ethnobotanical study in Guraferda District is crucial to document and analyze the traditional knowledge and practices of the local people concerning medicinal plants for treating human illnesses, thereby contributing to the conservation and utilization of biodiversity. Furthermore, comparing the findings of this study with the Ethiopian ethnobotanical medicinal plant database will offer valuable insights into the regional distribution and utilization of medicinal plants, enhancing our understanding of Ethiopia's significant traditional plant-based healthcare system. With this in mind, the current study aims to gather, identify, and document medicinal plants and the associated indigenous knowledge used by local people to treat various human ailments in the study area. Additionally, it seeks to identify threats to medicinal plants and conservation practices while selecting medicinal plant species with high informant consensus and fidelity level values for future phytochemical analyses.

Materials and methods

Description of the study area

The research was conducted in the Guraferda District, situated in the Benchi-Sheko Zone of Southwest Ethiopia, approximately 602 km southwest of Addis Ababa and 42 km from Mizan Teferi. Geographically located between latitude 6°51′24.6′′N and longitude 35°20′02.1′′E, with an altitude range of 500–2500 m, the district spans 2565.42 km² and includes 32 kebeles and an administrative town named Biftu. The estimated population from 2014 to 2017 is 43,137, with 23,473 males and 19,664 females, predominantly residing in rural areas [11]. The 2023 report from the Guraferda District Health Office highlights several prevalent ailments in the district, including febrile illness, wounds, malaria, tonsillitis, and typhoid. However, the provision of healthcare services in rural areas of the district is insufficient. The report identifies a shortage of healthcare clinics, hospitals, medical equipment, reagents, tablets, skilled healthcare professionals, and logistical support as the main reasons for this deficiency (Fig. 1).

Fig. 1

Map of study site (generated by ArcGIS 10.4.1)

Climate

In the Guraferda District, the agro ecosystems comprise of predominantly lowland (wet qolla) areas, accounting for 78% of the total area, while the midland (Woynadaga) areas make up the remaining 22%. The mean yearly temperature of the region is 21.1 °C, while the average annual precipitation is approximately 1974 mm (Fig. 2).

Fig. 2

The climate diagram of Biftu town illustrates the distribution of rainfall and variation in temperature over the period of 2002 to 2022

Research methods

Reconnaissance survey

A preliminary investigation was carried out between September 12 and 29, 2023, in order to acquire data and develop a cognitive representation of the kebeles landscape that would be sampled. The individuals involved were identified, and a suitable timeframe for data collection was established. Approaches for gathering and arranging information relating to the existing TMPK wereided upon.

Research design

The research methodology employed in this study encompassed a cross-sectional design, which effectively combined qualitative data in a non-numerical format, specifically in the form of images, with quantitative data that were presented using descriptive and inferential statistics.

Study site and informant selection

The study sites and informants were selected through information gathered from various sources like the Guraferda District administration, health, and agricultural offices, as well as local residents. This ensured a comprehensive understanding of the area. Eight kebeles (Table 1) were chosen based on factors like proximity to Biftu, healer presence, infrastructure, and security concerns [2, 11]. A total of 96 informants, aged 18 to 80, were interviewed during the study. Twelve individuals were selected from each of the eight kebeles. Thirty-two key informants were chosen through purposive sampling based on recommendations, while 64 general informants were selected through snowball sampling from the local population in the study area as proposed by [12]. The study included participants aged 18–80, categorized into young adults (18–30), middle-aged (31–55), and elderly (56–80) groups [13]. The focus was on individuals under 30 to investigate knowledge transfer on medicinal plants between generations [14].

Table 1 Altitude, Latitude, Longitude, Easting and Northing of Selected Sample Kebeles

Methods of ethnobotanical data collection

Ethnobotanical surveys were conducted in selected kebeles within Guraferda District to gather information on traditional medicinal plants. The data collection process continued until no new information on new medicinal plants emerged. In order to obtain the required information, interviews were conducted with local healers, community members, and traditional medicine practitioners using the following methods.

Semi-structured interview

Semi-structured interviews were conducted in the local languages of Sheko, Meinit, Benchi, Wolyita, Amharic, Oromiffa, Kaffa, and Sidamo with the help of a translator. Participants shared personal details and information on medicinal plants, including indigenous names, usage, habitats, availability, preparation, dosage, and administration. Interviews also covered plant conservation, additional ingredients in remedies, side effects, antidotes, knowledge sources, and knowledge transfer methods. Traditional healers were asked about their practice duration and compensation. The goal was to document medicinal plant whereabouts, threats, conservation practices, comprehensive uses, and non-medicinal applications. This approach was influenced by [12, 15].

Group discussion

To gather community-level information on traditional medicinal plants (TMPs), focus group discussions were held in each kebele with an average of five participants per group. Excluding the 96 previously selected informants, topics covered included TMP knowledge, threats, conservation, modernization impact, and commercialization. Discussions were open and interactive, allowing free expression of opinions.

Field observation

Field observations were carried out to facilitate extensive communication with individual informants, allowing for the identification and collection of medicinal plants that are traditionally utilized in their natural environment.

Guided field walk

Proper field guides were consulted for guided field walks in accessible yet potentially hazardous sites. Selection was based on participants' navigation skills and knowledge of local plant species. During walks, sensory experiences like visual observations and interactions with traditional healers aided in identifying medicinal plants. Voucher specimens were collected using digital photography in various settings.

Market survey

A market survey in the District covered five major markets to assess the marketability of traditional medicinal plants (TMPs). Data on availability, price, and units were collected and analyzed to determine usage and revenue potential. Samples of TMP vouchers were collected with local assistance. Verbal interviews with market stakeholders provided insights on marketing practices, cultivation, availability, threats, prices, and economic value [16].

Plant collection, identification, and herbarium preparation

Data were collected from November 2023 to January 2024 with informant’s assistance. Plant species were collected with respondent assistance, and a medicinal plant inventory was compiled with local names and photographs. Information on remedies was gathered from traditional medicine practitioners and informants through semi-structured interviews. Plant collection involved assigning local names, pressing, drying, and mounting specimens as noted by [14]. Fruit and seed preservation involved envelopes and plant presses. Identification was done in the field and at Mizan-Tepi University using taxonomic keys and online tools. Voucher specimens were preserved in the university's herbarium for future reference.

Data analysis

The field data were collected, compiled, categorized, and documented, including local and scientific plant names, families, life forms, parts used, and habitats in Microsoft Word 2019. The analysis utilized frequency tools like pie charts, bar graphs, and tables. Descriptive statistics (mean and standard deviation) were calculated using R program version 4.3.2. Normality was assessed with Shapiro–Wilk test before t test. An independent t test examined gender disparities in TMPK based on reported plants. Another t test explored knowledge variations among education levels and healing experiences. ANOVA assessed knowledge differences by age groups. Linear regression and Pearson correlation analyzed the relationship between age and reported plants [18].

Quantitative analysis of ethnobotanical data

Ethnobotanical data analysis was conducted by employing the R software version 4.3.2, in conjunction with manual formulation.

Plant part value (PPV)

The plant part value calculation presents the percentage of plant parts like stems, leaves, roots, fruits, bark, and flowers used for biopharmaceutical purposes, following the methodology by [17], and it is computed in the following manner:

$${\text{PPV}}\left( {\text{\% }} \right){ } = \frac{{\sum {\text{RU }}_{{\left( {\text{plant part}} \right)}} { }}}{{\sum {\text{RU}}}} \times 100$$

where ∑RU_{(plant part)} represents the sum of the cited plant parts and ∑ RU represents the total number of cited uses for a given plant.

Preference ranking

A study was carried out to determine the preference order of TMPs for treating human and domestic animal ailments, using data collected from ten key informants. Medicinal plants were evaluated and ranked according to their effectiveness using scores. Similarly, a preference ranking of threatening factors impacting TMPs was established by randomly selecting 10 key informants as outlined by [16].

Direct matrix ranking

The direct matrix ranking was conducted in order to compare multipurpose MPs commonly reported by informants following Cotton (1996). Based on the relative benefits obtained from each plant, five multipurpose MPs were selected out of the total medicinal plants and seven use categories of these plants were listed. Five key informants were chosen to assign use values to each attribute (5 = best, 4 = very good, 3 = good, 2 = less used, 1 = least used, and 0 = not used). Using the information provided by the informants, the average value of each use-diversity for a species was calculated, and the values for each species were then summed up and ranked accordingly [12, 16, 18].

Informant consensus factor (ICF)

The ICF study identified key human ailments in the district and potential medicinal plants for treatment. Traditional remedies were categorized into ten groups. The ICF formula is:

$$\text{ICF }=\frac{\text{Nur}-\text{Nt}}{\text{Nur}-1}$$

where Nur = number of use reports from informants for a particular plant-use category; Nt = number of taxa or species that are used for that plant use category for all informants. The index ranges from 0 to 1, with values nearing 1 signifying a strong consensus among informants in the utilization of the same species [19].

Fidelity level (FL)

The relative healing potential of medicinal plants in treating human ailments was assessed by employing a fidelity level (FL), as proposed by [20]. The computation of fidelity level (FL) was carried out using the following formula:

$$\mathbf{F}\mathbf{L}(\text{\%})=\frac{\mathbf{I}\mathbf{P}}{\mathbf{I}\mathbf{U}}\times 100$$

where FL = fidelity level or relative healing potential, IP = the number of informants who independently cited the importance of a species for treating a particular ailment (frequency of citation of a species for a particular aliment), and IU = the total number of informants who reported the medicinal plant for a given disease (total number of citations of that species).

Ethical clearance

The Guraferda District Administration Office collaborated with the Department of Biology at Mizan-Tepi University (MTU) to conduct research in kebeles. District Administrations granted permission for fieldwork after acknowledging cooperation letters. Official authorization letters were sent to various offices and sample kebeles. This collaboration aimed to enhance community involvement, facilitate data collection, and provide guidance during interviews. Chairpersons of kebeles provided cooperation letters, data on households, recommended key informants, and arranged interview meetings. Informants gave oral consent during group discussions before sharing ethnobotanical knowledge willingly during interviews.

Results and discussion

Sociodemographic attributes of informants in the study area

In this study, a total of 96 participants were involved. The majority of the participants were male, accounting for 83.3% (n = 80), while the remaining 16.7% (n = 16) were female. When considering the healing experience, the majority of the participants were classified as general informants, making up 66.7% (n = 64), followed by key informants at 33.3% (n = 32). The age range of the participants included in the study varied from 18 to 80 years old. Among them, the largest proportion fell within the age group of 56–80, comprising 53.1% (n = 51), followed by the age group of 31–55, accounting for 30.2% (n = 29). The education levels of the participants ranged from illiteracy to college level. The majority of the participants were found to be illiterate, representing 70.8% (n = 68), followed by those who had completed elementary school at 21.8% (n = 21). In terms of marital status, the majority of the participants were married at 82.2% (n = 79), followed by single individuals at 13.5% (n = 13) (Table 2).

Table 2 Sociodemographic characteristics of respondents

Medicinal plant knowledge among different ethnic groups

The information on the dissemination of medicinal knowledge among the most referenced ethnic groups in the Guraferda District provides insight into the diverse traditional healing practices deeply embedded in the cultural heritage of the Sheko, Amhara, Meinit, and Kefa communities. These ethnic groups, with percentages of 33.3%, 20.8%, 14.6%, and 11.5%, respectively, are recognized as preservers of valuable medicinal wisdom transmitted across generations. Their profound connection to local flora and fauna, as well as cultural customs, likely contributes to their higher reported percentages. Conversely, the Sidama and Wolyita ethnic groups, with percentages of 3.1%, seem to possess lower levels of documented medicinal knowledge, indicating a potential necessity for further investigation and documentation of their traditional healing methods. This contrast underscores the importance of acknowledging and safeguarding the diverse range of medicinal knowledge upheld by various ethnic groups within the Guraferda District to leverage the potential advantages for healthcare practices in the area. The distribution of medicinal knowledge among the most cited ethnic groups in the Guraferda District of Ethiopia reveals a complex interplay between cultural practices, environmental factors, and historical traditions. The significantly higher percentages reported by the Sheko, Amhara, Meinit, and Kefa ethnic groups highlight the deep-rooted connection these communities have with their natural surroundings and traditional healing practices. Their reliance on local flora and fauna for medicinal purposes underscores the intimate relationship between culture and nature, where indigenous knowledge is passed down through generations as a vital part of community identity.

The lower reported percentages of medicinal knowledge among the Sidama and Wolyita ethnic groups suggest a potential divergence in traditional healing practices within the Guraferda district. This could be attributed to a variety of factors, including historical influences, access to resources, and cultural assimilation. Further exploration into the specific medicinal practices of these ethnic groups could provide valuable insights into the diversity of healing traditions present in the region and help bridge gaps in healthcare access and understanding.

Medicinal plants naming related to culture in the study area

The nomenclature of medicinal plants often incorporates meanings that are related to their use or other suggestive information about the plants. This information was uncovered by examining the local names assigned to various medicinal plant species. Among these species, some of the local names directly indicate their medicinal properties, while others describe physical attributes such as growth form, trunk color, leaf shape, toxicity, taste, and smell. It is important to mention that all of the medicinal plant species studied have local names in one or more languages spoken in the districts being investigated. These names are occasionally used interchangeably or with slight variations in pronunciation among different communities. Additionally, there are cases where a single local name is used to refer to multiple species that possess similar medicinal properties.

For instance, the local name “Qey Shnkur” is used to refer to Allium cepa L. due to the red color of its bulb. Similarly, “Gutichaa” is used for Acmella caulirhiza Delile because its leaves resemble the shape of an earring. “Wotetie” is the local name for Lactuca serriola L., chosen because of its sap that resembles milk. “Yeayit jero” is used to describe Centella asiatica (L.) Urb, as its leaf structure resembles that of a rat's ear. “Michi-charo” is the local name for Ocimum lamiifolium Hochst. ex Benth., as it is known to locally cure febrile illness called “mich.” Lastly, “Shiferaw” is the local name for Moringa oleifera Lam., as it is believed to treat various diseases.

Traditional medicinal plants used to treat human ailments

Diversity of medicinal plants in Guraferda district

The utilization of medicinal plants by the inhabitants of Guraferda District was investigated, resulting in the identification of a total of 81 species. These species belong to 38 families and 71 genera of plants (Table 12). The local population relies on these plants to address a wide range of human ailments, encompassing approximately 40 different ailments. This finding surpasses the numbers reported in Ethiopia by [21,22,23,24,25], which reported 60, 29, 63, 72, and 12 plant species, respectively. Similarly, compared to reports from other parts of the world by [26,27,28], which reported 42, 55, and 37 plant species, respectively, the number of medicinal plants found in Guraferda District is higher. The variation in the number of medicinal plants found in different study areas may be attributed to factors such as the area of vegetation type, the number of informants involved in the study, the time of data collection, and the duration and culture of the area, as suggested by [29]. The prevalence of herbal treatments for human ailments in Guraferda District indicates the reliance of the local population on traditional medicines. This reliance may be influenced by factors such as the high cost of modern medications, the limited availability and accessibility of modern health services, and the cultural acceptance of herbal medicines, as also observed in other regions of Ethiopia by [30,31,32].

Notably, the families Asteraceae and Solanaceae were the most frequently mentioned, with each accounting for 11.1% of the species cited (9 species each). Additionally, the families Euphorbiaceae, Cucurbitaceae, Fabaceae, and Rutaceae were also mentioned, representing 6.2% and 5 species each, and 4.9% and 4 species, respectively (Table 3). This suggests that these plant families were widely utilized for the treatment of human ailments. This finding aligns with previous reports from Ethiopia [25, 33,34,35,36,37] as well as other countries worldwide [38, 39]. In contrast, the families Fabaceae, Poaceae, Amaranthaceae, and Apocynaceae were frequently reported in Pakistan [40]. This could be attributed to the wider distribution and abundance of these plant families in the flora region, in terms of the number of taxa [29]. This indicates that easily accessible plant species are often preferred by individuals, as long as they are not harmful [41, 42].

Table 3 Total list of families with number of genera, species and rank

Growth form of medicinal plants

The findings of the study indicate that medicinal plants can be categorized into different groups based on their habits. Among these groups, herbs were found to be the most abundant, comprising 55.5% of the total number of species recorded (45 species). Following herbs, shrubs constituted 22.2% (18 species), while trees accounted for 16% (13 species) (Fig. 3). Climbers, on the other hand, represented the smallest proportion with only 6.2% (5 species). The abundance of herbal species may be due to favorable climate conditions, such as high rainfall. Herbs are preferred for treating ailments due to their availability and effectiveness, as noted by scholars [2, 33], both locally and globally [38, 40, 43]. This trend could be seen as positive for plant conservation, as herbs have shorter growth cycles and require less space for cultivation compared to trees. However, seasonal herbs may not be accessible at certain times, especially if sourced from the wild [8].

Fig. 3

Growth forms of medicinal plants for human Ailments

In contrast, a larger number of studies have reported the use of shrubs and trees [9, 13, 44,45,46], both locally and globally [47,48,49,50,51,52,53]. This could be due to their annual availability and their ability to withstand drought and invasive alien species, making them suitable for widespread use [13]. Furthermore, this suggests a variation in medicinal plant utilization due to differences in culture, agroecologies, topographic features, and the ease of access to the species [54].

Habitat of medicinal plants

The collection of medicinal plants in the study area involved sourcing from diverse outlets, namely the wild, home gardens, and the market. Out of the 81 medicinal plants identified, 38 (47%) were procured from the wild, 19 (23.4%) from home gardens (HG), 15 (18.5%) from the market, and 9 (11.1%) from both the wild and home gardens (Fig. 4). Human activities are shrinking these habitats due to population growth, jeopardizing many wild medicinal plants. This aligns with global reliance on wild habitats for medicinal plants. Efforts to cultivate and sustainably use these plants are needed to reverse the line. This information is supported by the work of [55,56,57,58], as well as research conducted by [53, 59, 60].

Fig. 4

Sources of medicinal plants for human ailments

Medicinal plant parts used for human ailments

The study's findings indicated that 12 specific parts of medicinal plants were identified as the primary constituents utilized for addressing various health problems. The analysis of plant parts, based on the total frequency of citations by informants, demonstrated that out of a total of 213 reports on plant parts, the most commonly employed components for the preparation of remedies were leaves (47%, 100), roots (20.1%, 43), seeds (11.1%, 25), bulbs (6.1%, 13), and fruits (5.2%, 11). Furthermore, stem and rhizome (2.3%, 5 each), the whole part (1.4%, 3), as well as flower, latex, bark, and tuber (0.9%, 2 each) were also mentioned by the informants (Fig. 5). This aligns with other studies showing leaves are frequently used in traditional medicine due to their availability, ease of use, and effectiveness due to high concentration of secondary metabolites. However, over-harvesting leaves during dry seasons can be challenging and harmful to plants' reproductive processes. This information is supported by the work of various researchers, such as [9, 11, 31], and elsewhere in the world [61,62,63].

Fig. 5

Most cited medicinal plant parts

Contrary to these findings, other studies have reported the prevalence of roots over other plant parts, as well as stems and whole plants, in traditional medicine. This information was supported by the work of various researchers, such as [2, 23, 44], and elsewhere in the world [45, 59, 65,66,67,68,69]. Year-round accessibility of fresh roots makes them a popular choice for medicine, but over-harvesting threatens medicinal plants like Securidaca longepedunculata Fresen and Echinops kebericho Mesfin in Guraferda District. Similarly, studies conducted in other parts of Ethiopia and the worlds have indicated that overutilization of root parts poses a threat to medicinal plants such as [2, 59].

Forms of medicinal plant used for human ailments

The analysis results for the condition of the plant used, based on the frequency of citations by informants, revealed that out of the total 226 reports on plant usage, the majority of medicinal plants were found to be prepared solely from fresh plant materials (65.4%, 148). Following this, a significant portion of medicinal plants were prepared from dry conditions (31.4%, 71). A small percentage of medicinal plants (3.2%, 7) were prepared exclusively from either fresh or dry plant material (Fig. 6). This finding aligns with previous research conducted by various scholars who also reported the use of freshly collected plant parts for traditional medicine preparation [2, 13, 41, 69]. Furthermore, similar practices have been observed in different parts of the world [47, 51, 62]. Traditional healers argue that the healing potential of certain medicinal plants diminishes if they are not used in their fresh condition. Consequently, there appears to be limited utilization of dry storage for future use, as highlighted by previous studies [2, 70, 71]. Due to the lack of efforts in conserving dried plant matter, the frequent gathering of fresh plant parts may pose a threat to the plants, particularly during dry seasons. The reliance of local communities on fresh plant parts can be attributed to the perceived effectiveness of these species in therapy, as the beneficial ingredients are not lost during the drying process. However, this dependency on fresh plant materials also poses a potential risk for the loss of these valuable medicinal plants [41, 72].

Fig. 6

Forms of medicinal plant used for human ailments

Mode of medicinal plants preparation

Different approaches were utilized to create the traditional remedy, taking into account the nature of the ailments, as well as the condition and components of the medicinal plant. Pounding was the preferred method for preparing dried plant parts, whereas crushing was employed for fresh ones. The research findings highlighted that informants reported a total of 211 modes of preparation frequency for medicinal plants. Notably, the majority of plants were prepared by crushing (66.4%, 140), followed by powdered (18%, 38), and concoction (15.6%, 33) (Fig. 7). Crushing aids quick bioactive extraction for immediate relief, often using single plant parts or mixtures from different plants. These findings align with similar results reported by [8, 76, 77] both locally and globally [78]. In contrast, other studies have found that powdering was the dominant method of traditional medicine preparation by local people, as observed in the works of [75, 79, 80] as well as in various cultural groups worldwide [37, 64].

Fig. 7

Mode of medicinal plants preparation for human ailments

Route of medicinal plant administration and application

The study found that informants mentioned route of administration 173 times. Oral administration was most common (54.3%, 94 citations), followed by dermal (34.1%, 59 citations) and nasal (8.1%, 14 citations) routes. Other routes like optical, auricular, vaginal, and anal each accounted for 1.2% (2 citations) and 0.6% (1 citation), respectively (Fig. 8). This trend is in agreement with findings from various studies in Ethiopia [23, 35, 81] and globally [39, 52, 64, 68]. This preference for oral and dermal routes may be attributed to the effectiveness of these methods in rapidly interacting with pathogens' physiology and enhancing curative potency, as well as the prevalence of internal ailment in the study area. Dermal administration is favored due to its lower potential for absorption and toxicity, and its ease of application for patients, as supported by previous reports [23, 44, 82]. The treatment was administered through various methods, including creams and tying for dermal administration, and chewing, eating, and drinking for oral administration. Nasal administration involved fumigating and inhaling, while auricular administration entailed dropping the solution into the ear. Optical administration included the use of ointments or drops, and anal administration involved dropping or creaming. Vaginal administration was carried out by inserting the treatment, consistent with the findings of [33, 36, 83].

Fig. 8

Most cited route of medicinal plant administration for human ailments

Diagnosis and treatment methods of patients

In Guraferda District, 40 human ailments were reported, with malaria, typhoid, wound, stomachache, diarrhea, tonsillitis, ringworm being most prevalent (Table 12). The community relies more on traditional healers than modern medicine. Common symptoms include diarrhea, fever, itching, sweating, weakness, headaches, and discomfort. Healers diagnose through visual inspection and interviews, assessing symptoms like skin color, throat condition, and body temperature. Treatment involves herbal remedies for swellings, direct application or bandaging for wounds, and chewing medicinal plants for throat and abdominal issues. Economic, cultural, and availability factors drive the community's preference for traditional healthcare over distant centers. Similar trends are seen globally. These factors were highlighted by [2, 13, 55], as well as in studies conducted elsewhere in the world by [39, 59]. Local healers primarily use visual inspection for diagnosis, identifying disorders based on body temperature, skin color, appetite, and appearance. Similar diagnostic methods have been reported by other researchers in Ethiopia [2, 13, 55] as well as in different cultural groups worldwide [73, 74]. Misidentification of ailment due to these methods can lead to incorrect diagnoses and inappropriate prescriptions, potentially resulting in adverse effects on the patients. This issue has been highlighted by [75].

Medicinal plants dosage and antidotes

In the study area, various units of measurement and timeframes were used by the local community for medicinal dosages. These included finger widths, hand sizes, and liquid measuring tools like fera and gini, as well as numerical approximations for plant parts. This observation aligns with the findings of [82, 84, 85]. The findings indicated that dosages of remedies for various ailments were determined based on factors such as the patient's age, pregnancy status, physical characteristics, and gender, with traditional healers lacking standardized measurements or guidelines. This observation was consistent with the work of [24, 41, 80]. Informants reported minimal side effects from traditional medicines. Overdosing caused issues like vomiting, diarrhea, burning sensations, and fainting, especially with plants like Phytolacca dodecandra, Justicia schimperiana, and Datura stramonium. This outcome is consistent with the findings of [2, 56, 82, 86]. In the study area, traditional healers used antidotes like niger seed, sorghum borde, sugar, honey, coffee, tea, water, butter, milk, yogurt, bulla, teff porridge, barley, and rice broth to stabilize disorders. This finding is consistent with reports from other parts of the country, as documented by [24, 41, 80].

Marketability of medicinal plants

Out of the 15 species of medicinal plants examined, only five were actively sold for medicinal use: Echinops kebericho Mesfin, Securidaca longepedunculata Fresen, Olea europaea, Clausena anisata, Artemisia abyssinica, and Withania somnifera. The rest were sold in bulk for non-medicinal purposes but used as medicine when needed. In local markets like Megenteya, Semerta, Gabika, Meleya, and Bebeka, prices varied: Echinops kebericho and Securidaca longepedunculata roots cost 10 Ethiopian Birr, while Artemisia abyssinica, Withania somnifera leaves, Olea europaea, and Clausena anisata stem slices were priced at 20 Birr. Other plants like Solanum americanum and Brassica nigra were sold in bulk for non-medicinal uses but also used in traditional medicine.

Efficacy of medicinal plants used for treating human ailments

The ICF results showed higher consensus factors for human ailments in the study area, particularly in the dermal (ICF = 0.90), and digestive system (ICF = 0.88). Conversely, the musculoskeletal & nervous system category had the lowest ICF value (0.60) (Table 4), suggesting limited sharing of knowledge among traditional healers. This lack of interaction may be due to distance and secrecy. Different habitats may lead healers to use different medicinal plants for the same ailments. Informants shared important knowledge on medicinal plants for common ailments, even though some species had lower use values, indicating their effectiveness despite being known by only a few healers. These findings are consistent with the reports of [87,88,89,90].

Table 4 ICF values of TMPs used for treating human ailments

Relative healing potential of medicinal plants

The fidelity level of medicinal plants reflects their effectiveness for specific ailments. In this study, plants like Cissampelos mucronata A. Rich (FL = 1, 100%) for stomachaches, Bidens pilosa L. (FL = 1, 100%) for wounds, and Musa accuminata Colla. (FL = 0.73, 73%) for eczema showed high efficacy. Plants with high FL values should be conserved and managed. Conversely, plants like Ocimum lamiifolium Hochst.ex Benth (FL = 0.42, 42%) had lower healing potential for fevers, as indicated by their lower FL values (Table 5). These findings are consistent with the results reported by [2, 55, 91, 92].

Table 5 Fidelity levels of 10 most cited TMPs for human ailment treatments

The most preferred plants for treating human ailments

The findings indicated that the local community's preference for medicinal plants was based on their experiences and their ability to distinguish effective plants for treating their ailments. Among the plants used for treating wounds, Bidens pilosa L. was the most favored species, followed by Datura stramonium L. and Commelina benghalensis L. Conversely, Sida rhombifolia and Croton macrostachyus were found to be the most preferred plant species for wound treatment (Table 6), contrasting the previous findings [29, 92, 93]. The local community heavily relies on plants for various purposes, including construction, food, and medicine. Cordia africana Lam. is ranked as the most threatened, while Securidaca longepedunculata Fresen and Olea europaea (Wall. ex G. Don) Cif are preferred for multiple uses in Guraferda District. Conservation efforts are needed to protect these valuable plant species. This finding aligns with the findings of [30, 55, 56, 77, 83, 94] which indicated that Cordia africana Lam. was a multipurpose medicinal plant in their respective study areas. In contrast, the report of [23, 95] revealed that Croton macrostachyus Del. was the most multipurpose plant species.

Table 6 Preference ranking of TMPs reported for treating wound

Medicinal plants like Echinops kebericho Mesfin in Guraferda District are at risk due to high market demand for their roots, leading to scarcity. This finding aligns with the conclusions drawn in the works of [2, 9, 34, 79, 96,97,98,99,100].

Direct matrix ranking of multipurpose medicinal plants

The output of the direct matrix ranking (DMR) exercise on five multipurpose medicinal plants used for treating human ailments enabled to identify which of the multipurpose plants is under greater pressure than other species in the area along with the respective factors that threaten the plants. Accordingly, Cordia africana Lam. was ranked first (most—threatened) followed by Securidaca longepedunculata Fresen and Olea europaea (Wall. ex G. Don) Cif (Table 7). Results indicated that these multipurpose medicinal plant species are currently exploited more for construction, firewood and timber production purposes than for their medicinal uses.

Table 7 DMR score of five TMPs for human ailments

Comparison of knowledge among different informant groups

Comparison of knowledge between key and general informants

Key informants scored significantly higher (5.6 ± 1.5) in medicinal plant knowledge than general informants (2.5 ± 1.4), with a t-value of 9.6 and p < 0.05, indicating a substantial difference. Key informants demonstrate superior understanding of traditional medicinal practices compared to general informants in the study area. This finding is consistent with the conclusions drawn in the works of [11, 31, 77, 83, 101]. In contrast to this finding, the report of [76] indicated that there was no significant difference in medicinal plant knowledge between key informants and general informants. The substantial knowledge gap between key and general informants underscores the value of leveraging key informants' expertise in medicinal plants. Targeted education can bridge this gap, fostering sustainable practices and preserving traditional knowledge.

Comparison of knowledge between gender

Male informants had higher average knowledge scores (3.9 ± 1.9) compared to female informants (1.8 ± 1.2), with a significant difference indicated by a t-value of 5.3 (p < 0.05) (Table 8). This outcome aligns with the findings of [11, 30, 83, 102, 103]. Contrary to this discovery, [104] found that females possess more knowledge about medicinal plants than males. Moreover, other researchers, such as [77, 101], reported that both males and females have equal knowledge of medicinal plants. Gender disparities in medicinal plant knowledge within the community highlight potential cultural, social, or historical factors influencing knowledge acquisition and transmission between male and female informants. Furthermore, other researchers [11, 102] noted that traditional knowledge on medicine is typically passed down to sons rather than daughters in many parts of Ethiopia through verbal communication. Therefore, such bias may have contributed to the observed difference. Additionally, healers may prefer males to pass on their indigenous medicinal plant knowledge because of the belief that only males can access plant species in distant sites and forests. These findings underscore the need for targeted interventions to address gender disparities in traditional medicinal knowledge. Further research is essential to develop inclusive programs and policies that empower women and promote gender equality in resource management.

Table 8 Medicinal plant knowledge among informant groups (independent t test)

Comparison of knowledge among different age groups

A one-way analysis of variance (ANOVA) was performed using R software to investigate the impact of age category (young, middle, and elder) on the scores of medicinal knowledge among informants. The results of the ANOVA indicated a significant main effect of age category (F (2, 93) = 15.53, p < 0.05), suggesting that there were notable differences in medicinal knowledge scores across the three age categories. The variance between the groups (age) (SS = 118.2, MS = 59.08) was considerably higher than the residual or within-groups variance (SS = 353.7, MS = 3.80) (Table 9), indicating that the disparities in medicinal plant knowledge were influenced by the age categories of the participants.

Table 9 Age categories with informant medicinal plant knowledge (one-way ANOVA)

Further analysis using Tukey's HSD post hoc tests revealed that the elder group exhibited significantly higher mean scores (M = 4.3, SD = 2.2, p < 0.05) compared to both the middle group (M = 3, SD = 1.6, p < 0.05) and the young group (M = 1.3, SD = 0.9, p < 0.05). These findings imply that older informants tend to possess more extensive knowledge of medicinal plants compared to younger informants. This discrepancy may be attributed to the transmission of cultural traditions and practices across generations, as well as the increased exposure to traditional medicine practices over time. This study aligns with the research of [13, 30, 31, 83, 102], and others in different countries [38], which also found that older individuals cited more medicinal plant species than younger individuals. This may be due to the elders' extensive experience in using local medicinal plants for various ailments in traditional ways, while younger generations are influenced by modernization and globalization, leading to areas interest in traditional practices.

The research highlights the importance of conserving traditional medicinal practices. Age influences knowledge of medicinal plants, informing targeted educational programs. Variation across age groups underscores older generations' expertise. A strong positive correlation (r = 0.722) confirms age-related knowledge differences, with older individuals possessing greater expertise (Fig. 9). This significant relationship emphasizes the need to preserve and pass on traditional medicinal knowledge. This finding aligns with the findings of [13, 76, 83, 102]. The regression analysis found β0 and β1 estimates of − 1.43 and 0.1, respectively, with p < 0.05 significance. Age categories show a significant correlation with medicinal plant knowledge. The β0 of − 1.43 indicates the lowest age category's projected knowledge. β1 of 0.1 shows a positive relationship between age and knowledge (Fig. 10). The R-squared value of 0.523 reveals age explains 52.3% of knowledge variance, emphasizing its impact. Older informants have more medicinal plant knowledge, highlighting traditional wisdom importance. This study underscores the value of older generations' expertise in traditional medicine practices, emphasizing the need to preserve and pass on their knowledge.

Fig. 9

Correlation model for medicinal plant knowledge by informant age

Fig. 10

Regression model for medicinal plant knowledge by informant age

Transfer of traditional medicinal knowledge

In the study area, traditional medicinal plant knowledge is orally transmitted within families, often by eldest sons, with some sharing with trusted neighbors and relatives. These findings are consistent with the research of [90, 91, 106]. Older generations hold valuable traditional knowledge on medicinal plants, but this is endangered due to elders' passing. Modern influences like medicine, education, and societal changes contribute to this line. Traditional healers keep their knowledge private to maintain healing power and income. Secrecy is crucial for indigenous healers known as Tenquay (Magician). This finding aligns with the outcomes of numerous additional investigations [29, 41, 82, 90, 98, 106, 107]. Moreover, Younger generation's reluctance to learn traditional medicine threatens loss of valuable information as older healers pass without sharing knowledge [41, 98, 108]

Threats and conservation practices of medicinal plants

The deforestation, overharvesting, invasive species, and lining use of traditional medicine due to modernization are key risks to medicinal plants (Table 10). Excessive harvesting of Echinops kebericho root for fumigation and Securidaca longepedunculata for treatment of various ailments, along with habitat loss for agriculture, threatens these plants (Table 11). The study highlights deforestation as the main threat to medicinal plants in the districts, consistent with research in other Ethiopian regions. Loss of valuable information is also a concern as younger generations show reluctance to learn traditional medicine from older healers [36, 90, 100, 109, 110].

Table 10 Preference ranking to find out the most threatening factors of TMPs

Table 11 Preference ranking to find out the most threatened TMPs

Invasive species like Parthenium hysterophorus and Lantana camara threaten medicinal plants in Gurafeda District, outcompeting local species and disrupting the ecosystem balance, potentially leading to extinction [78, 111,112,113,114]. This has emerged as a key factor contributing to the line of herbaceous medicinal plants. Furthermore, other researchers have highlighted Prosopisiflora as another invasive alien species posing a threat to medicinal plant species [70, 114]. Likewise, the research indicates that multipurpose species are especially at risk, as they encounter various threats. This discovery aligns with earlier studies [34, 90, 91, 107] (Table 12).

Table 12 Traditionally used medicinal plants for human ailments in Guraferda District

These medicinal plant species were not solely grown for medicinal purposes; rather, they were also used for food, spices, commercial value, and other applications. The most commonly employed cultivation methods for medicinal plant species included home gardens (Ruta chalepensis L.), coffee shade (Cordia Africana Lam.), live fences (Justicia schimperiana (Hochst. Ex Nees) T. Anders.), roadsides (Eucalyptus globulus Labill.), and agricultural fields mixed with other crops. The findings also suggest a lack of community-based conservation efforts undertaken by the local population in the district. This observation is consistent with previous research [91, 108, 115].

Conclusion and recommendation

Conclusion

The lack of concerted efforts to conserve medicinal plants and indigenous knowledge in the Guraferda District is indeed concerning. Traditional practitioners play a crucial role in preserving this valuable heritage, but their limited cultivation efforts indicate a need for external support. Government intervention is essential to create a comprehensive conservation strategy that includes both the preservation of plant species and the safeguarding of traditional knowledge. Supporting traditional practitioners in cultivating medicinal plants in homegardens can help ensure a sustainable supply of these valuable resources. By providing training, resources, and incentives, the government can empower local communities to take an active role in preserving their natural and cultural heritage. In addition to cultivation, measures such as establishing protected areas, promoting sustainable harvesting practices, and conducting research on medicinal plants can contribute to their long-term conservation. Collaborative efforts involving government agencies, local communities, and other stakeholders are crucial to effectively address the challenges facing medicinal plant conservation in the district.

Recommendation

Based on the study's findings, it is recommended to avoid uprooting medicinal plant species prematurely and instead focus on utilizing other plant parts like leaves. This will help safeguard the species from extinction. Collaborating with traditional healers to conduct scientific research can validate the efficacy and safety of traditional remedies. In situ and ex situ conservation strategies should be developed, prioritizing plants with remedial roots and high value. Establishing a traditional healers' association with professional support can enhance healthcare integration. Setting up medicinal plant nurseries in partnership with the Agriculture Office can aid in propagating preferred species for cultivation. Implementing these recommendations will support sustainable use and conservation of medicinal plants, ensuring their availability for future generations and promoting the fusion of traditional and modern healthcare systems.