Factors in hybridization of local medical systems: Simultaneous use of medicinal plants and modern medicine in Northeast Brazil.

The presence of mainstream medicine in local medical systems inserts a set of external treatments and concepts that generate adjustments in the local conceptions of health and disease. What points in the system are most receptive to change? Who are the residents most likely to adopt these external treatments to deal with diseases? To answer these questions, this work used a study model consisting of the simultaneous use of medicinal plants and modern medicine, testing whether diseases that require greater treatment efforts are the main targets of adherence to modern medicine and if socioeconomic characteristics of residents can cause intracultural variation in relation to simultaneous use. To obtain socioeconomic data on the knowledge of medicinal plants and simultaneous use of these resources with modern medicine, semistructured interviews were conducted in a rural community that has easy access to modern medicine. Participatory workshops were held to access the local perceptions about the frequency of occurrence and severity of illnesses. A multilevel logistic regression model was applied for data analysis. We found that chronic, severe and frequently occurring diseases in the community tended to show greater simultaneous use locally. Among the socioeconomic factors, we determined that high educational levels positively influenced the combined use of plants and modern medicine. The need to ensure the cure of frequent, severe and chronic diseases is a factor that leads residents to seek a greater number of possible treatments, stimulating the combined use of plants and modern medicine. Residents with higher educational levels were more likely to use a combination of treatments than those with lower educational levels, demonstrating that more participation in formal education may facilitate the combined use of medicinal plants and modern medicine.