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Journals / Akademik Açı / 2026 / Cilt: 6 Sayı: 2

Income and literacy: Understanding the dilemmas and beliefs in marketability of Orthodox healthcare products

Gelir ve okuryazarlık: Ortodoks sağlık hizmeti ürünlerinin pazarlanabilirliğine ilişkin ikilemleri ve inançları anlamak

Ogbonnaya Ukeh Oteh(Michael Okpara University of Agriculture, Umudike, Abia State)0000-0001-9561-6294
Ambrose Oloveze(Michael Okpara University of Agriculture Umudike, Abia State Nigeria)0000-0003-0320-9793
Adaku Queen Oteh(Michael Okpara University of Agriculture, Umudike, Abia State)0009-0005-3410-7126
Joyce Nneka Ozioko(Michael Okpara University of Agriculture, Umudike, Abia State)0009-0002-9092-1905
Victoria Onya(Alex Ekwueme Federal University Ndufu Alike Ebonyi State Nigeria)0000-0003-8958-5356
Pages
228–259
Publication Date
2026-10-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The study contributes context-specific evidence to healthcare marketing research and suggests that communication, trust and ethical conduct warrant further investigation.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The coexistence of traditional and orthodox healthcare practices in Nigeria raises questions about the cultural, ethical and socioeconomic factors influencing acceptance of orthodox healthcare products.
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Key Findings & Data:A cross-sectional survey of 332 adult consumers was used.
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Conclusion & Impact:The study contributes context-specific evidence to healthcare marketing research and suggests that communication, trust and ethical conduct warrant further investigation.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:sağlık ürünleri · kültür · cinsiyet

Abstract

The coexistence of traditional and orthodox healthcare practices in Nigeria raises questions about the cultural, ethical and socioeconomic factors influencing acceptance of orthodox healthcare products. This study examines the issues of the dilemmas and beliefs with the perceived marketing of orthodox healthcare products, taking income and literacy into account. A cross-sectional survey of 332 adult consumers was used. Descriptive statistics, factor analysis, OLS, and hierarchical and logistic regression were used in the analysis. The results reveal a significant effect of ethical beliefs after controlling for income and literacy level while also confirming the probabilities of predictor factors being in the female gender group, thereby presenting a significant contribution to healthcare management and marketing theory by clarifying the contextual factors that situates gender for required healthcare interventions. The findings highlight the relevance of ethical concerns in consumers’ evaluations of orthodox healthcare products, while also showing the need to interpret literacy and cultural belief results in light of measurement and sampling limitations. The study contributes context-specific evidence to healthcare marketing research and suggests that communication, trust and ethical conduct warrant further investigation.

Özet

Nijerya'da geleneksel ve ortodoks sağlık uygulamalarının bir arada bulunması, ortodoks sağlık ürünlerinin kabulünü etkileyen kültürel, etik ve sosyoekonomik faktörler hakkında soruları gündeme getirmektedir. Bu çalışma, gelir ve okuryazarlık düzeyini dikkate alarak, ortodoks sağlık ürünlerinin algılanan pazarlamasıyla ilgili ikilemleri ve inançları incelemektedir. 332 yetişkin tüketiciden oluşan kesitsel bir anket kullanılmıştır. Analizde tanımlayıcı istatistikler, faktör analizi, OLS ve hiyerarşik ve lojistik regresyon kullanılmıştır. Sonuçlar, gelir ve okuryazarlık düzeyi kontrol edildikten sonra etik inançların önemli bir etkisini ortaya koyarken, aynı zamanda tahmin edici faktörlerin kadın cinsiyet grubunda olma olasılığını da doğrulamaktadır; böylece, gerekli sağlık müdahaleleri için cinsiyeti konumlandıran bağlamsal faktörleri açıklığa kavuşturarak sağlık yönetimi ve pazarlama teorisine önemli bir katkı sunmaktadır. Bulgular, tüketicilerin ortodoks sağlık ürünlerini değerlendirmelerinde etik kaygıların önemini vurgularken, aynı zamanda okuryazarlık ve kültürel inanç sonuçlarının ölçüm ve örnekleme sınırlamaları ışığında yorumlanması gerektiğini de göstermektedir. Bu çalışma, sağlık hizmetleri pazarlama araştırmalarına bağlama özgü kanıtlar sunmakta ve iletişim, güven ve etik davranış konularının daha fazla araştırılmayı hak ettiğini öne sürmektedir.

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Cite This Article

Oteh, O. U., Oloveze, A., Oteh, A. Q., Ozioko, J. N., Onya, V. (2026). Income and literacy: Understanding the dilemmas and beliefs in marketability of Orthodox healthcare products. Akademik Açı, Cilt: 6 Sayı: 2, 228–259. https://doi.org/10.59597/akademikaci.2041734

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References (81)

  1. Abhadionmhen, A. O., Imarenezor, E. P., & Ogodo, A. C. (2025). Socioeconomic and cultural factors influencing traditional medicine (TM) use in Nigeria: A systematic mixed-method review. European Journal of Integrative Medicine, 74, Article 102436. https://doi.org/10.1016/j.eujim.2025.102436
  2. Adewuyi, E. O., Zhao, Y., Auta, A., & Lamichhane, R. (2017). Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey. Scandinavian Journal of Public Health, 45(6), 675-682.
  3. Afolabi, F. J., De Beer, P., & Haafkens, J. A. (2020). Orthodox or traditional medicine? Private or public healthcare? Exploring treatment pathways for occupational health problems among informal automobile artisans. Social Science & Medicine, 265, Article 113510.
  4. Ajima, O. G., & Ubana, E. U. (2018). The concept of health and wholeness in traditional African religion and social medicine, Arts and Social Sciences Journal, 9(4), 2-5.
  5. Ajisegiri, W. S., Abimbola, S., Tesema, A. G., Odusanya, O. O., Peiris, D., & Joshi, R. (2023). “We just have to help”: Community health workers’ informal task-shifting and task-sharing practices for hypertension and diabetes care in Nigeria. Frontiers in Public Health, 11, Article 1038062. https://doi.org/10.3389/fpubh.2023.1038062
  6. Akakpo, M. G., & Neuerer, M. (2024). The relationship between health literacy and health-seeking behavior amongst university students in Ghana: A cross-sectional study. Health Science Reports, 7(5), Article e2153. https://doi.org/10.1002/hsr2.2153
  7. Alfadi, A. A., Izham, M., Ibrahim, M., Maraghi, F. A., & Mohammad, K. S. (2016). An examination of income effect on consumers’ ethical evaluation of counterfeit drugs buying behavior: A cross-sectional study in Qatar and Sudan. Journal of Clinical and Diagnostic Research, 10(9). https://doi.org/10.7860/JCDR/2016/19526.8410
  8. Anaka, A., & Srinivas, V. (2020). Addressing the ethical challenge of market inclusion in base-of-the-pyramid markets: A macromarketing approach. Journal of Business Ethics, 164(2), 243-260.
  9. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1-10.
  10. Aranmolate, R. A. (2025, March 6). The state of healthcare in Nigeria: Challenges and opportunities. Plastic surgery diary. https://gml.com.ng/the-state-of-healthcare-in-nigeria-challenges-and-opportunities
  11. Asakitikpi, A. E. (2019). Healthcare coverage and affordability in Nigeria: an alternative model to equitable healthcare delivery. In Universal Health Coverage (p. 45). IntechOpen.
  12. Badiora, A. I., & Abiola, O. B. (2017). Quality of life (QoL) of rural dwellers in Nigeria: A subjective assessment of residents of Ikeji-Arakeji, Osun-State. Annals of Ecology and Environmental Science, 1(1), 69-75.
  13. Bagozzi, R. P., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Science, 16(1), 74-94.
  14. Bairagdar, N., Reich, A., & Franck, J. B. (2021). Impact of marketing to improve patient access to care and clinic utilization for clinical pharmacy specialists. Mental Health Clinician, 11(2), 59-63.
  15. Barnes, J. (2022). Advances in methods and techniques in pharmacovigilance for herbal and traditional medicines and other natural health products. In J. Barnes (Ed.), Pharmacovigilance for herbal and traditional medicines: Advances, challenges and international perspectives (pp. 93-139). Springer. https://doi.org/10.1007/978-3-031-07275-8_7
  16. Bensalem, S., & Benouhiba, N. (2025). The Impact of Marketing Strategy on Cultural Values: Analyzing the Consumer-Brand Relationship from a Socioeconomic and Cultural Perspective. Journal for Educators, Teachers and Trainers, 16(1), 166-175.
  17. Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107.
  18. Bertakis, K. D., Azari, R., Helms, L. J., Callahan, E. J., & Robbins, J. A. (2000). Gender differences in the utilization of health care services. The Journal of Family Practice, 49(2), 147-152.
  19. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong II, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293-302.
  20. Boas, F. (1887). Museums of ethnology and their classification. Science, 9(228), 587-589. https://doi.org/10.1126/science.ns-9.228.587.b
  21. Bourke, M. (2023). The fascinating traditions of healing and medicine in African cultures. Med-life. https://www.medlifemovement.org/medlife-stories/global-topics/the-fascinating-traditions-of-healing-and-medicine-in-african-cultures/
  22. Brosnan, S., & De Waal, F. (2003). Monkeys reject unequal pay. Nature, 425(6955), 297-299. https://doi.org/10.1038/nature01963
  23. Budhathoki, P., Adhikari, K., & Koirala, R. (2019). The Gap between Attitudes and Behavior in Ethical Consumption: A Critical Discourse. Quest Journal of Management and Social Sciences, 1(2), 285–295. https://doi.org/10.3126/qjmss.v1i2.27446
  24. Burnett, K., Sanders, C., Halperin, D., & Halperin, S. (2020). Indigenous Peoples, settler colonialism, and access to health care in rural and northern Ontario. Health & Place, 66, Article 102445. https://doi.org/10.1016/j.healthplace.2020.102445
  25. Castro, R., & Sáiz, P. (2020). Cross-cultural factors in international branding. Business History, 62(1), 1-25.
  26. Cheong, H. S., & Park, S. C. (2017). Cultural marketing strategies in global markets: Case studies from Korea and China. International Marketing Review, 34(4), 596-617.
  27. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159. https://doi.org/10.1037/0033-2909.112.1.155
  28. Eagly, A. H., & Wood, W. (2012). Social role theory. In P.A.M. Van Lange et al. (Eds.), Handbook of theories of social psychology (pp. 458-476). Sage.
  29. Eche, M. W. (2023). Culture as the foundation of philosophy: A critical evaluation of Theophilus Okere’s hermeneutical approach to African philosophy. Augustinian Journal of Philosophy and Theology, 5(1), 1–24.
  30. Enebeli, M. O. (2025). Relationship between health literacy and level of education on health-related behaviors of the Nigerian population in Anambra State. African Journal of Health, Nursing and Midwifery, 8(3), 28-56.
  31. Faasse, K., & Newby, J. (2020). Public perceptions of COVID-19 in Australia: Perceived risk, knowledge, health-protective behaviors, and vaccine intentions. Frontiers in Psychology, 11, Article 551004. https://doi.org/10.3389/fpsyg.2020.551004
  32. Geta, E. T., Wakjira, A., & Hailu, W. B. (2023). Disparities in modern health utilization across socio-demographic and economic inequalities among household in Gida Ayana District, Oromia Regional State, Ethiopia: A community-based cross-sectional study. BMC Health Services Research, 23(1), Article 597. https://doi.org/10.1186/s12913-023-09527-z
  33. Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (2006). Multivariate Data Analysis (6th ed.). Pearson Educational International.
  34. Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). Prentice Hall.
  35. Hawkins, D. I., Best, R. J., & Coney, K. A. (1983). Consumer Behavior: Implications for Marketing Strategy. Business Publications.
  36. Hernandez, M., & Gibb, J. K. (2020). Culture, behavior and health. Evolution, Medicine, and Public Health, 2020(1), 12-13. https://doi.org/10.1093/emph/eoz036
  37. Hofstede, G. (2001). Culture’s consequences: Comparing values, behaviors, institutions and organizations across nations (2nd ed.). Sage.
  38. Iwu, M. M. (1982). African ethnomedicine – based on a seminar delivered at Institute for medical research, UPS: Nsukka, Nigeria.
  39. Jin, J., Zhao, Q., & Santibanez-Gonzalez, E. D. R. (2020). How Chinese consumers’ intentions for purchasing eco-labeled products are influenced by psychological factors. International Journal of Environmental Research and Public Health, 17(1), Article 265. https://doi.org/10.3390/ijerph17010265
  40. Kankeu, H.T., Saksena, P., Xu, K., et al., (2016). The role of informal payments in healthcare systems. A study from Cameroun Health Policy Plan, 31(7), 872-879.
  41. Kaur, J., & Chawla, R. (2016). Impact of Culture on Marketing Strategies. Imperial Journal of Interdisciplinary Research, 2(3), 325-330.
  42. Khan, M. A., & Law, L. S. (2018). The role of national cultures in shaping the corporate management cultures: A three-country theoretical analysis. In J. Vveinhardt (Ed.), Organizational culture (pp. 3-26). IntechOpen. https://doi.org/10.5772/intechopen.78051
  43. Khan, S., & Abbas, M. (2023). Interactive effects of consumers’ ethical beliefs and authenticity on ethical consumption and pro-environmental behaviors. Journal of Retailing and Consumer Services, 71, Article 103226. https://doi.org/10.1016/j.retconser.2022.103226
  44. Khokhotva, O., & Elexpuru Albizuri, I. (2020). Teachers’ educational beliefs change through lesson study: Implications for school culture. International Journal for Lesson and Learning Studies, 9(4), 317-331. https://doi.org/10.1108/IJLLS-04-2020-0016
  45. Kimenju, S. C., & De Groote, H. (2008). Consumer willingness to pay for genetically modified food in Kenya. Agricultural Economics, 38(1), 35-46.
  46. Kumar, R., & Pal, R. (2018). India achieves WHO recommended doctor population ratio: A call for paradigm shift in public health discourse! Journal of Family Medicine and Primary Care, 7(5), 841-844. https://doi.org/10.4103/jfmpc.jfmpc_218_18
  47. Latif, A. S. (2020). The importance of understanding social and cultural norms in delivering quality health care—A personal experience commentary. Tropical Medicine and Infectious Disease, 5(1), Article 22. https://doi.org/10.3390/tropicalmed5010022
  48. Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563-575.
  49. Mordeniz, C. (Ed.). (2019). Traditional and complementary medicine. IntechOpen. https://doi.org/10.5772/intechopen.78452
  50. Mothibe, M. E., & Sibanda, M. (2019). African traditional medicine: South African perspective. In C. Mordeniz (Ed.), Traditional and complementary medicine. IntechOpen. https://doi.org/10.5772/intechopen.83790
  51. Mumley, W. E. (2019). Organizational culture and ethical decision-making during major crises. The Journal of Values-Based Leadership, 12(2), 9, https://doi.org/10.22543/0733.122.1274
  52. Nie, W., Medina-Lara, A., Williams, H., & Smith, R. (2021). Do health, environmental and ethical concerns affect purchasing behavior? A meta-analysis and narrative review. Social Sciences, 10(11), Article 413. https://doi.org/10.3390/socsci10110413
  53. Nikiforova, A., & Voronova, N. (2023). Immersive practices in the modern cultural space (world and domestic experience). Filosofiya i Kul'tura, (5), 60-73. https://doi.org/10.7256/2454-0757.2023.5.40731
  54. Nwokolo, N., Onwujekwe, O., McKee, M., Ojiakor, I., Angell, B., & Balabanova, D. (2025). Household health-seeking behavior and response to informal payment: Does economic status matter? Health Economics Review, 15(1), Article 83. https://doi.org/10.1186/s13561-025-00654-3
  55. Okeme, A. B. K., Godwins, O. P., Gusen, M. J., Gbaa, T., Pam-Tok, A. O., & Uwe, V. E. (2024). Understanding the impact of cultural factors on healthcare outcomes: A data-driven comparison of US and Nigerian healthcare systems. American Journal of Human Psychology, 2(1), 146-158.
  56. Okojie, P. W., & Lane, R. (2020). Healthcare options and factors influencing health-seeking behavior in a rural community in Nigeria: A cross-sectional study. Christian Journal for Global Health, 7(2), 83-92. https://doi.org/10.15566/cjgh.v7i2.335
  57. Oloveze, A. O., Ogbonna, C., Ahaiwe, E., & Ugwu, P. A. (2022). From offline shopping to online shopping in Nigeria: Evidence from African emerging economy. IIM Ranchi Journal of Management, 1(1), 55-68.
  58. Oloveze, A. O., Okonkwo, R. V. O., & Onya, O. V. (2023). Strategies for sustainable consumption behavior. The case for Food and Beverages Industry Products: Nigerian students’ perspective. FUOYE Journal of Accounting and Management, 6(1), 173-187.
  59. Oloveze, A. O., Oteh, O. U., Nwosu, H. E., & Obasi, R. O. (2022). How user behaviour is moderated by affective commitment on point of sale terminal. Rajagiri Management Journal, 16(1), 2-20.
  60. Oloveze, A. O., Oteh, O. U., Okonkwo, R. V. O., Chukwuoyims, K., Ollawa, C. C., Ugwu, P. A., & Ogbonna, C. (2021). Consumer motivation and multilevel marketing on health products. Health Economics and Management Review, 2(3), 97-112.
  61. Omonzejele, P. F. (2008). African concepts of health, disease and treatment: An ethical inquiry. Explore, 4(2), 120-126.
  62. Onoka, C. A., Onwujekwe, O. E., Uzochukwu, B. S., & Ezumah, N. N. (2013). Promoting universal financial protection: Constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria. Health Research Policy and Systems, 11(1), Article 20. https://doi.org/10.1186/1478-4505-11-20
  63. Onwujekwe, O., Hanson, K., Uzochukwu, B., Ichoku, H., Ike, E., & Onwughalu, B. (2010). Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria. Tropical Medicine & International Health, 15(1), 18-25.
  64. Oteh, O. U., Oloveze, A. O., Obasi, R. O., & Opara, J. O. (2021). Consumer health knowledge: Cultural norms and marketing of healthcare products. Health Economics and Management Review, 2(1), 8-22.
  65. Oteh, O. U., Oloveze, A. O., Emeruem, O. L., & Ahaiwe, E. O. (2023). Celebrity endorsement in African context: TEARs model approach. Revista de Gestão, 30(4), 334-347.
  66. Pfeiffer, J., Li, H., Martez, M., & Gillespie, T. (2018). The role of religious behavior in health self-management: A community based participatory research study. Religions, 9(11), Article 357. https://doi.org/10.3390/rel9110357
  67. Popoola, O. O., Adebisi, I. A., Adeyemi, A. S., Adepitan, D. S., & Oladeru, O. F. (2025). Assessing ethical practices among community pharmacists in Nigeria: Prevalence, drivers, challenges and implications – A mixed methods survey. Frontiers in Public Health, 13, Article 1495328. https://doi.org/10.3389/fpubh.2025.1495328
  68. Rosli, M. S., Saleh, N. S., Alshammari, S. H., Ibrahim, M. M., Atan, A. S., & Atan, A. N. (2021). Improving questionnaire reliability using construct reliability for researches in educational technology. International Journal of Interactive Mobile Technologies, 15(4), 109-116. https://doi.org/10.3991/ijim.v15i04.20199
  69. Sahara Reporters. (2025, November 15). Over 4000 doctors, dentist left Nigeria in 2024 alone amid health sector crisis. https://saharareporters.com/2025/11/15/over-4000-doctors-dentists-left-nigeria-2024-alone-amid-healthsector-crisis
  70. Salmorin, D. E., & Gepty, V. (2023). Cultural practices & beliefs in abaca farming of the indigenous people. Journal of Humanities and Social Sciences Studies, 5(2), 22–32. https://doi.org/10.32996/jhsss.2023.5.2.4
  71. Singh, A., Divate, V., Khare, S., Raut, R., & Rathod, M. (2020). How Does Culture Affect Consumer Buying Behaviour? International Journal for Research in Engineering Application & Management, 6(4), 111-113.
  72. Taherdoost, H. (2016). Validity and reliability of the research instrument: How to test the validation of a questionnaire/survey in a Research. International Journal of Academic Research in Management, 5(3), 28-36.
  73. Ugwu, U. T., & Okpala, C. O. (2024). Cultural beliefs and healthcare utilization in Anambra State, Nigeria. African Journal of Social and Behavioral Sciences, 14(6), 3442-3457.
  74. Uzochukwu, B., Ughasoro, M. D., Etiaba, F., Okwuosa, C., Envuladu, E., & Onwujekwe, O. E. (2015). Healthcare financing in Nigeria: Implications for achieving universal health coverage. Nigerian Journal of Clinical Practice, 18(4), 437-444.
  75. Van Rooij, B., & Fine, A. (2018). Toxic corporate culture: assessing organizational processes of deviancy. Administrative Sciences, 8(3), Article 23. https://doi.org/10.3390/admsci8030023
  76. Varkey, B. (2021). Principles of clinical ethics and their applications to practice. Medical Principles and Practice, 30(1), 17-28.
  77. Wang, J., Pham, T. L., & Dang, V. T. (2020). Environmental consciousness and organic food purchase intention: A moderated mediation model of perceived food quality and price sensitivity. International Journal of Environmental Research and Public Health, 17(3), Article 850. https://doi.org/10.3390/ijerph17030850
  78. Workneh, T., Emirie, G., Kaba, M., Mekonnen, Y., & Kloos, H. (2018). Perceptions of health and illness among the Konso people of southwestern Ethiopia: persistence and change. Journal of Ethnobiology and Ethnomedicine, 14(1), Article 18.
  79. World Bank. (2012). World Development Report 2012: Gender Equality and Development. https://openknowledge.worldbank.org/entities/publication/51c285f6-0200-590c-97d3-95b937be3271
  80. World Health Organization. (2023). Gender and health. https://www.who.int/health-topics/gender
  81. Yu, Y., & Stoet, G. (2020). Encountering non-Christian Chinese international students: Cross-cultural adaptive practices of local Christian organisations in the UK. Journal of Beliefs & Values, 41(3), 305–321.