The study was conducted in the North West province of South Africa, which is bordered by Botswana to the north, the Kalahari Desert to the west, Gauteng province to the east, and the Free State to the south. The province covers 104881.67 km² and has a population of 3 509 953 people. It has more sunny days and higher average rainfall per year than the South African average, making it advantageous for agriculture (North West Province 2024). The North West province is divided into four district municipalities, which are further subdivided into 18 local municipalities. The four district municipalities of the North West province are, Bojanala Platinum District Municipality; Dr Kenneth Kaunda District; Dr Ruth Segomotsi Mompati District; and Ngaka Modiri Molema District Municipality (Figure 1). The province is known as the Platinum province for its abundance of the underground metal (North West Province 2024).

Ngaka Modiri Molema and Dr Ruth Segomotsi Mompati are the two poorest rural district municipalities in the North West province. Dr Ruth Segomotsi Mompati District Municipality is considered the rural hinterland of the province, with vast rural areas containing scattered, small, low-level urban nodes (North West Province 2015). The majority of economic activities in the North West province are concentrated in the southern region between Potchefstroom and Klerksdorp in the Dr Kenneth Kaunda District Municipality, as well as Rustenburg in the Bojanala Platinum District (North West Province 2013). Mining is the largest contributor to the economy of the North West province, representing almost a quarter of South Africa’s mining industry as a whole. The province produces gold from Orkney and Klerksdorp, uranium from Klerksdorp, platinum from Rustenburg and Brits, and diamonds from Lichtenburg, Christiana, and Bloemhof. The province accounts for 20% of South Africa’s mining industry, and over 90% of the country’s platinum comes from its mines. The province is also renowned for cattle farming, particularly in areas around Stella (North West Province 2015).

The study utilised the Within-Stage Mixed Model (Johnson & Onwuegbuzie 2004) for both quantitative (QUANT) and qualitative (qual) data. Data collection, analysis, and interpretation were triangulated, and closed-ended and open-ended questions were strategically combined. Quantitative data were analysed statistically, while qualitative data were analysed thematically. Themes from qualitative data supplemented or elaborated on responses to closed-ended questions.

The study targeted veterinarians and animal health technicians (AHTs) employed by the South African Government in the Sub-Directorate of the Animal Health, Directorate of Veterinary Services, North West Provincial Department of Agriculture and Rural Development (DARD). The target population was 141 individuals at the time of inquiry, and 53 participants were sampled using a non-probability sampling technique (convenience sampling) (Etikan et al. 2016) because of its low cost and availability of the target population in certain governmental events. Data were collected at various locations across the North West province including the South African Association for Animal Health Technicians (SAAAHT) North West Provincial Congress 2016, three State Veterinary offices, and the Provincial Rabies Day campaign.

A self-administered questionnaire was designed with closed-ended and open-ended questions adapted from Adjei (2013) and Sabarinathan Nair, Rao and Ramkumar (1997). Validity was pre-tested. Closed-ended questions had multiple-choice questions and a 5-point Likert scale. Open-ended questions were for participants to clarify or complement responses provided to close-ended questions.

IBM-Statistical Package for Social Science version 24.0 (International Business Machines Corporation (IBM), Armonk, New York State, United States [US]) was used to analyse quantitative data. Descriptive statistics were generated, including frequencies, percentages, mean, and standard deviations of variables. The Chi-square test determined associations between demographic characteristics and two variables that determined awareness and perceptions. However, the inferential statistics performed on the data are only applicable to the sample in this study as non-probability sampling was used in the study. A thematic analysis was conducted on the qualitative data to generate themes following the framework proposed by Braun and Clarke (2006), and the themes were then reported in narratives.

The tool’s validity was tested by piloting it at North-West University’s Mafikeng campus. The pilot study included eight veterinarians, three AHT participants from the Centre of Animal Health Studies, and two staff members from the Department of Agricultural Extension and Economics who had expertise in questionnaire design. Feedback from the participants was used to determine the content validity of the questionnaire. After scrutinising and responding to the questionnaire, participants had one-on-one sessions to provide feedback on the tool. The instrument was revised based on their recommendations.

The Institutional Research Ethics Regulatory Committee of the North-West University approved the research (Ethics number: NWU-00554-16-A9). The research proposal was submitted to the Chief Director of Veterinary Services of the North West Provincial Department of Agriculture and Rural Development (DARD) for permission to collect data among state-employed animal healthcare practitioners (AHCPs). An agreement was reached with the Chief Director of Veterinary Services that data can be collected after informed consent was obtained from AHCPs who were willing to participate. The AHCPs received an introductory letter attached to the self-administered questionnaire, explaining the details and purpose of the study. Participants were informed that participation was voluntary and completing and submitting the questionnaire indicated informed consent to participate. The data collection process respected the participants’ rights.

A total of 53 participants took part in the study. Males comprised the majority at 56.6% (Table 1). The most common age range was 30–40 years at 32.1%. A total of 79.2% of the participants were AHTs, with 92.5% of the sample being black people, and 37.7% employed in the Ngaka Modiri Molema District Municipality. All four district municipalities in the North West province were represented in the sample.

A majority at 77.4% (n = 41/53) of AHCPs in the study were aware of ethnoveterinary medicinal practices. There was no significant difference between awareness among veterinarians (72.7%) and AHTs (78.6%). Participants were aware of several diseases treated using EVM including, diarrhoea (n = 23), wounds (n = 21), poisoning (n = 16), and constipation (n = 16) as shown in Figure 2. The use of EVM by farmers was attributed to its local availability and affordability (56.10%), as well as the lack of access to Western veterinary services (41.46%) and the ease of application (36.59%) as shown in Table 2. However, most practitioners did not believe that farmers use EVM because of its effectiveness as only 12.2% indicated that farmers use EVM because of its effectiveness.

The sources of information on EVM for AHCPs were identified in the study. The findings showed that indigenous communication networks, such as farmers, community members, and family members, were the primary source of awareness about EVM among AHCPs, as indicated in Table 2. Among these networks, community members (including farmers) were the most significant source of information (70.7%), followed by family members (39.0%).

The study aimed to gauge approval of EVM use by farmers using a 5-point Likert scale. The majority approved the use of EVM by farmers with a mean of 3.57 (standard deviation [s.d.] = 1.016) on the agreement scale which ranged from 1 (not in agreement) to 5 (in agreement). The highest percentage of participants (57.4%) approved the use of EVMs by farmers, while 29.8% were not sure if they support the use of EVM by farmers and 12.8% totally opposed the use of EVM by farmers.

Thematic analysis of the narrative by AHCPs to explain the reasons they approved or opposed the use of EVM by farmers identified four main themes, two against (themes 1 and 2) and two in favour (themes 3 and 4). Themes identified are as follows: (1) Ethnoveterinary medicine is unscientific; (2) Use of EVM interferes with Western veterinary services; (3) Ethnoveterinary medicine is an alternative or complementary to Western veterinary medicine; and (4) Ethnoveterinary medicine is effective. Theme 1 and 2 will be presented first.

The study found that most participants (65.8%) were uncertain about the effectiveness of EVM. However, a smaller percentage (22.0%) believed that EVM was effective, while only 12.2% perceived it as ineffective. The study also revealed that the lack of scientific proof (n = 41/41) and limited availability of ingredients (n = 40/41) were the greatest limitations of EVM as an alternative or complementary to Western veterinary medicine as indicated in Figure 3.

According to the study, 20.8% (n = 11/53) of AHCPs use EVM to treat a total of 15 diseases. The diseases were, retained placenta, internal parasites, gall sickness (bile reflux), eye infection, metritis, fracture, poisoning, external parasites, constipation, bloat, wounds, diarrhoea, heartwater, redwater, and lumpy skin disease. Participants used EVM either because they trusted the remedies (54.5%) or were experimenting (36.4%) or when modern medicine failed (18.2%) or took too long to heal (27.3%), or when farmers requested it (27.3%).

As shown in Figure 4, participants recommend scientific testing of EVM for safety and efficacy (n = 40/41). They also suggest documenting EVM plants and their uses, (n = 19/41) as well as providing licenses for traditional medicine practitioners (n = 19/41).

The Chi-square test revealed an association between the district of employment and awareness of EVM (H_a5). The null hypothesis was rejected at χ² = 17.490, df = 3, and p = 0.001. Table 3 displays that AHCPs at Dr Ruth Segomotsi Mompati had the highest awareness of EVM (100%), while those at Dr Kenneth Kaunda had the lowest (16.7%). The Chi-square test revealed no associations between AHCPs’ agreement with the use of EVM and their gender, age, profession, or professional experience.

The majority of AHCPs in this study are aware of ethnoveterinary medicinal practices used by farmers. The study dispels the notion suggested by Toyang et al. (1995) that EVM is practised in secret. The high level of awareness among AHCPs in the North West province indicates the presence of a rich amount of ethnoveterinary knowledge among farmers and communities, as well as a willingness to share this knowledge. However, the smaller percentage of AHCPs who are unaware of EVM could be linked to their location of employment (rural or urban), and type of farming (commercial or communal). Ethnoveterinary medicine is mostly practised among rural and/or poor farmers (Luseba & Van der Merwe 2006; Masika, Van Averbeke & Sonandi 2000; McGaw & Eloff 2008), indicating that AHCPs stationed in commercial farming areas or urban areas are likely to be uninformed about EVM.

The study found that participants employed in Ngaka Modiri Molema, Bojanala, and Dr. Ruth Segomotsi Mompati District Municipalities had higher awareness of EVM practices compared to those in Dr Kenneth Kaunda. The location and economic profiles of the districts influenced the study’s findings. Most AHCPs in Dr Kenneth Kaunda are based in urban state veterinary offices in economic hubs like Potchefstroom and Klerksdorp. This suggests that they provide services to urban, peri-urban, and commercial farmers who do not use EVM. On the other hand, Dr Ruth Mompati, the most rural and poor district in the province, had all AHCPs aware of EVM. The socio-economic characteristics of the district have resulted in the communities’ reliance on EVM instead of expensive Western medicine, which explains the level of awareness of EVM practices among Western-trained animal health practitioners.

The results of this study when compared with Indian studies conducted by Jirli, Jha and Chugh (1997) and Sabarinathan Nair et al. (1997) show that AHCPs in India are more proficient in EVM issues than the participants in this study. In a study conducted by Jirli et al. (1997), 15 AHCPs were evaluated for their knowledge and acceptance of EVM at the National Dairy Research Institute in Karnal, Haryana. The participants were veterinarians and almost all were aware and over half of them demonstrated practical knowledge of EVM for specific animal health treatments. Sabarinathan Nair et al. (1997) conducted a survey on ethnoveterinary medicinal practices in Pondicherry, Tamil Nadu, and Kerala states. The findings showed that over three-fifths of AHCPs used EVM to treat various ailments. The study by Jirli et al. (1997) and Sabarinathan Nair et al. (1997) found higher awareness and knowledge in EVM in India compared to the South African counterparts in this current study, likely because of India’s more established EVM system and research (Hoareau & DaSilva 1999). In addition, in India it is common practice for AHCPs to integrate EVM with Western medicine (Sabarinathan Nair et al. 1997).

The study found that indigenous communication networks are the main source of knowledge for AHCPs regarding EVM, while Western communication networks like conferences play a minor role. This finding is similar to that of Jirli et al. (1997), who discovered that indigenous communication networks were the primary EVM knowledge source for participants. Thus, the current study revealed a gap in ethnoveterinary research and development in South Africa, specifically in sharing information at conferences attended by para-veterinarians and veterinarians. The researcher suggests promoting the new field of EVM extensively, making use of all available opportunities, including conferences, and targeting mainly AHCPs.

Individual perception determines acceptance of any phenomenon (Ogunniyi 2007). In this study, a moderate majority of AHCPs agreed with using EVM in farming. Similar findings among Western-trained healthcare practitioners (WTHCPs) in Limpopo and Gauteng provinces in South Africa were reported by Mokgobi (2012). The majority of WTHCPs accept traditional medicine as a primary healthcare system. Similarly, in the current study, some participants believe EVM is a good primary animal health system, especially for poor-resourced farmers and those in remote areas. Moderate agreement with traditional medicine use, including EVM, found in this and other studies including Mokgobi (2012) are positive predictors for government-suggested integration of Western and traditional medicine.

An interesting finding of this study is that although most participants agreed with the use of EVM by farmers, a higher number were uncertain about its effectiveness. This suggests that AHCPs tolerate EVM despite not seeing its value. The reason for this could be that most participants perceive EVM as lacking a scientific basis and, therefore, do not trust in its effectiveness. These concerns coincide with those of similar studies in either ethnomedicine or the field of ethnoveterinary by Sabarinathan Nair et al. (1997), Fielding (1997), Jirli et al. (1997), Hopa et al. (1998), Adjei (2013), Peltzer, Mngqundaniso and Petros (2006), Van Rooyen et al. (2015), Peu (2000), and Mokgobi (2012).

It is understandable why AHCPs would be worried about the lack of scientific testing, as this study points out. Their concerns are not without merit. A review of EVM in South Africa (McGaw & Eloff 2008) reported that majority of documented medicinal plants were not tested at the time and recommended further validation testing for the majority of the plant species. However, the lack of scientific validation for EVM is not limited to South Africa; Iqbal and Jabbar (2010) found the same trend in their global review of EVM research. Ethnoveterinary research and development is a new field in South Africa and the progress or lack thereof can be attributed to its early stages of development. However, significant research has been conducted on medicinal plants and their scientific validation as evident in South African reviews by McGaw and Eloff (2008), Chakale, Mwanza and Aremu (2021); Selogatwe et al. (2021). The uncertainty among AHCPs regarding the effectiveness of EVM may be because of a gap in the dissemination of information on ethnoveterinary research and development.

Another interesting finding was that some AHCPs also practice EVM, often because of trust in the practice. How and when did they learn to appreciate EVM? Their appreciation for EVM may have developed in childhood or later in life, influenced by sources such as parents or cultural upbringing, and shaped by past experiences or socio-cultural settings (Ellen, Lycett & Johns 2013; Kashyap 2016). These factors can contribute to the formation of positive perceptions of EVM, leading to its practice.