Harmonizing Traditional Knowledge with Environmental Preservation: Sustainable Strategies for the Conservation of Indigenous Medicinal Plants (IMPs) and Their Implications for Economic Well-Being

Abstract

The coexistence of traditional knowledge and environmental preservation presents a critical nexus in advancing sustainable development efforts, particularly concerning the conservation of indigenous medicinal plants. These plants play a dual role: they are essential components of traditional healing practices and are integral to economic stability, food security, and nutrition in communities worldwide. However, the rapid depletion of biodiversity and ecosystem degradation threaten the availability and sustainability of these vital resources. Despite their cultural and economic importance, there is a noticeable gap in the research addressing the conservation and sustainable use of indigenous medicinal plants, particularly focusing on the preservation of traditional knowledge systems. The existing literature often lacks comprehensive studies that document traditional knowledge practices related to medicinal plant conservation. Additionally, there is limited understanding of how the mismanagement of medicinal plant resources impacts the livelihoods of rural smallholder farmers who heavily rely on these plants for economic gains and food security. Hence, this study sought to explore and investigate the harmonious strategies that integrate traditional knowledge systems with modern conservation practices to safeguard indigenous medicinal plants on economic well-being in the Amatole District Municipality of the Eastern Cape. The study was conducted in 2023, and a structured questionnaire was used to capture the realities and experiences of prominent stakeholders (smallholder medicinal plant farmers). A multi-stratified sampling technique was used to draw up an appropriate sample of 150 smallholder farmers. Descriptive statistics and propensity-score matching were used for analysis. The study results indicated that the women farmers who are 44 years of average age and have 10 years of average schooling duration participate more in the production of indigenous medicinal plants. The average farm size per household is 1 ha, and it is reliant on an average of five members per household. The participation of women with indigenous medicinal plants underscores the significant role of women in traditional knowledge systems and sustainable agricultural practices, contributing to household income and community resilience. Additionally, the findings indicated that smallholder farmers are only aware of keeping indigenous medicinal plants by producing them in protected areas and on-farm conservation; other measures appear challenging to them. The study results reveal that knowledge of seed propagation, lack of knowledge of the implications of endangerment, the removal of forests with the motive of building houses, and, lastly, financial support were the constraints faced by smallholder farmers. Empirical results on the conservation and sustainable use of indigenous medicinal plants revealed that farmers are generating income to sustain the household as well as enhancing food and nutrition security. Based on the study results, it is recommended that government entities and policymakers are urged to prioritize supporting traditional knowledge, implement on-farm conservation, and foster sustainable agricultural practices to ensure biodiversity conservation, cultural preservation, and sustainable livelihoods. Enhancing targeted support for smallholder farmers, including access to land, agricultural services, and financial aid, alongside market development, ensures equitable benefits and sustainable livelihoods. Educational campaigns should raise awareness about indigenous medicinal plants’ ecological and economic importance, integrating traditional knowledge into formal education.

1. Introduction

Indigenous Medicinal plants constitute among the most important plants in the world on account of their healing power. For mere reasons of using these plants for healing diseases in human and animal-related conditions, humans have kept close contact with these plants in their societies [1]. They have multiple uses, such as healing diseases, healthy eating, and insect and pest repellent. The human community finds medicinal plants appealing because they are used in a wide range of applications. However, the greatest attraction is that they are more cheap than manufactured medicine [2]. It is noted that around 80% of the populations across various parts of the globe have adopted the practice of using herbal medicine for therapeutic purposes [3]. Significantly, the practice is particularly common in poor countries, where access to medicine is a struggle or it is very expensive.

The increase in human interest in indigenous medicinal plants has created opportunities for trade beyond Africa’s borders to other countries, especially in Europe. In Africa, it is estimated that over 700,000 tons of plant products valued at USD 150 million are harvested from the wild annually to satisfy human demand [4]. Similarly, [5] argued that South Africa has an annual dry and manufactured harvest of about 20,000 tons worth ZAR 270 million (USD 60 million). In Kenya, over 70% of the population uses homemade remedies as their primary source of medicine, and more than 90% utilize plant-based remedies at some point. Phytotherapy is a fundamental part of Kenyan communities, where indigenous knowledge has been passed down through generations. However, this practice is at risk due to industrialization and the adoption of Western lifestyles, leading to the erosion of traditional knowledge, which is often transmitted orally and remains undocumented. The indiscriminate trade of plant resources, uncontrolled harvesting methods, habitat changes, overexploitation, and climate change pose significant threats to the availability of medicinal plants in many developing countries. This situation underscores the urgent need for better conservation methods and the sustainable use of priority plant resources. In Kenya, ethnobotanical research has been ongoing since independence, resulting in several publications of guides and books documenting medicinal plant knowledge and usage. These are values that they extracted for the market, and indigenous medicinal plants in South Africa are traded through different avenues like small and big marketplaces. Local harvesters are raking in profits in the informal market of this country [6]. The inflated attention of consumers on medicinal plants has attracted various interest groups, including product developers, distributors, and extractors, who are seeking profits. Thus, rural farmers had an opportunity to grow medicinal plants and take advantage of the gap present in producing herbal plants [7,8]. The demand for indigenous medicinal plants creates an extra burden on biodiversity management because some plant species are critically endangered in the wild. Therefore, all indigenous medicinal plant species are susceptible to extinction; more so, farmers stand a chance of losing even high-value medicinal plants.

Smallholder farmers rely on indigenous medicinal plants to sustain their livelihoods. The value of indigenous medicinal plants can be measured by consumer importance, demand, and availability. An example is Agathosma betulina (Buchu), which has a huge profit margin, is well known worldwide, and forms part of exported products. According to [9], it was in 1761 that the first export of Cape Aloe to Europe took place. Hence, it becomes clear that indigenous medical plants form an important part of a very lucrative business [10,11]. Smallholder rural households living near these natural resources are good potential key role players in this industry, since these plants are situated at their convenience and close to access. It would result in sustainable profits and high benefits with minimal inputs if medicinal plants were permanently conserved. The availability of indigenous medicinal plants for smallholder farmers is threatened by the degradation of biodiversity in the wild. It is recognized in literature that several threats to indigenous medicinal plants and state that only very few medicinal plants, if any, are well propagated after harvest in these settings [4,5,12].

However, for smallholder farmers to become vital role players in the business of medicinal plants, they are bound to overcome numerous challenges. First, the awareness of profitable opportunities is at risk of loss due to the knowledge barriers that are challenging smallholder farmers. Village elders are knowledge holders, and indigenous medicinal plant information is transmitted through word of mouth. Hence, it is vulnerable to loss [13]. It is difficult to gauge the contribution made by smallholder indigenous medicinal plants towards livelihood enhancement, social welfare benefits, and employment, which are key economic indicators for measuring impact [14]. Also, reduced productivity due to no mechanical inputs on smallholder farms denies these producers a fair chance to be competitive in the market [15]. Therefore, with all of the above-mentioned being missing, it becomes difficult to measure the food security and nutrition security benefitted by smallholder farmers from the commercialization of medicinal plants. Medicinal plants not only hold significant cultural and medicinal value but also play a crucial role in biodiversity conservation and environmental sustainability. As demand for these plants increases globally, particularly in regions where traditional medicine is prevalent, effective conservation strategies are essential to ensure their long-term viability. In situ conservation methods, such as establishing protected areas and reserves, are critical for safeguarding medicinal plant habitats from overexploitation and habitat destruction. These protected areas not only preserve plant diversity but also maintain the ecological balance necessary for the sustainable harvest of medicinal plants.

The study endeavors to tackle the complex issue of harmonizing the traditional knowledge surrounding indigenous medicinal plants (IMPs) with the imperative of environmental preservation. At its core, this challenge revolves around striking a harmonious balance. On one hand, honor and preserve the rich traditional knowledge and practices associated with IMPs, which have been passed down through generations within indigenous communities, and on the other hand, ensure the sustainable use and conservation of these plants and the ecosystems they inhabit. This dual objective is crucial not only for preserving cultural heritage but also for maintaining the ecological integrity of these habitats, which are often delicate and biodiverse. Central to this study is the recognition that many IMPs play pivotal roles not only in traditional medicine but also in broader ecological systems. They often serve as indicators of environmental health and contribute significantly to biodiversity conservation. However, their sustainability is increasingly threatened by overharvesting, habitat loss, and climate change. Thus, the study seeks to explore innovative approaches and strategies that can reconcile the need for continued use of IMPs for medicinal purposes with robust conservation efforts. Additionally, it addresses the multifaceted challenge of harmonizing traditional knowledge of (IMPs) with environmental preservation amidst contemporary pressures and global environmental changes. This challenge encompasses navigating the complexities of sustainable resource management, cultural preservation, and ecological conservation within the context of rapidly evolving socio-economic dynamics and climate impacts. One critical aspect of the problem is the potential conflict between the traditional use of IMPs for medicinal purposes and the conservation of these plants and their habitats. Traditional knowledge often dictates specific harvesting practices and uses that have sustained communities for centuries, yet modern pressures, such as urbanization, agricultural expansion, and industrial development, increasingly threaten the habitats of these plants. Additionally, the impact of climate change adds further uncertainty, affecting the availability and distribution of IMPs and altering the ecosystems they rely on.

Many indigenous communities depend on the sustainable harvest and trade of medicinal plants for their livelihoods, yet unsustainable practices or external exploitation can lead to resource depletion and economic vulnerability. Balancing these economic imperatives with long-term conservation goals is crucial for ensuring the resilience and well-being of indigenous communities and promoting equitable development. In essence, the study encapsulates the intricate interplay between traditional knowledge systems, environmental sustainability, and socio-economic resilience.

The research at hand is dedicated to navigating the intricate challenge of harmonizing traditional knowledge related to indigenous medicinal plants with imperatives of environmental preservation through the formulation of sustainable strategies. This endeavor is fundamentally about striking a delicate balance. On one hand, preserve and respect centuries-old indigenous wisdom concerning medicinal plants, and on the other, ensure the conservation of these plants and their habitats for the benefit of future generations. By addressing this intersection, the study aims to mitigate potential conflicts that arise between traditional practices and contemporary conservation approaches, highlighting the crucial role of indigenous knowledge in biodiversity conservation and ecosystem health. By doing so, it not only aims to safeguard cultural heritage but also underscores the ecological significance of these plants within their natural habitats.

Furthermore, the research investigates the economic dimensions of conservation efforts surrounding indigenous medicinal plants, exploring how sustainable practices can contribute to the economic well-being of indigenous communities. This exploration not only underscores the potential economic value of preserving these plants but also considers how their sustainable management can lead to broader socio-economic benefits. The study aims to contribute to both the preservation of traditional knowledge systems and the long-term health of ecosystems, fostering a balanced and sustainable relationship between human societies and their natural environments. By promoting sustainable harvesting practices and exploring avenues for economic empowerment through value-added activities related to medicinal plants, the study seeks to illustrate how conservation efforts can align with and enhance local livelihoods, contributing to sustainable development goals in indigenous communities.

Therefore, the study contributes to the current literature on sustainable conservation strategies for indigenous medicinal plants. The main intention of the study is to weigh the impact of conservation strategies on the food and nutritional security of smallholder medicinal plant farmers. Not much is acknowledged about how much the conservation strategies influence food and nutrition security. Due to the unregulated nature of the medicinal plant industry, there is a limited measure of the influence of conservation strategies on the long-term effects of the overharvesting of medicinal plants. Furthermore, there are close to no studies at all that have tested the effect of indigenous conservational knowledge in environmental preservation, and neither have these strategies been investigated against food and nutrition status. Information on the above mentioned is crucial, as they enlighten about the improvement of standards of living, sustainable income, and food and nutrition security. Furthermore, the study aims to explore and investigate the harmonious strategies that integrate traditional knowledge systems with modern conservation practices to safeguard indigenous medicinal plants on economic well-being in the Amatole District Municipality of the Eastern Cape.

2. Methodology

2.1. Description of the Study

The study was conducted in the Amatole District Municipality (ADM) of the Eastern Cape. The district municipality is situated in the former Transkei region, which is mostly rural settlements, and some minority parts of it are peri-urban settlements. The Amatole District Municipality is classified as a category C2 Municipality that is comprised of 6 Local Municipalities that are distinguished as follows: Amahlathi; Great Kei; Mnquma; Ngqushwa; and Raymond Mhlaba. The district municipality is home to approximately 17 million people, with 91% being African, 6% white, and 3% coloured [16,17]. Furthermore, females cover 52% of the population, and the remaining 48% are males [17]. The climate of ADM is characterized by average temperatures fluctuating between 7 °C and 10 °C in cool dry seasons when it can be snowy and from 18 °C to 24 °C in the hot humid season. Adequate rainfall ranges from 750 mm to 1050 mm per annum [18]. Inside the boundaries of the ADM’s territory are richly endowed terrains bestowed with natural resources, ranging from succulent grazing grasslands to forests and marine life [19].

The Amatole District Municipality Integrated Development Plan (ADMIDP) estimates suggest that 54% of the population survives below the breadline [20]. Furthermore, 66% of the population survives through the assistance of social welfare grants because of the high levels of unemployment [20,21]. The majority of the dwellers of the district are involved in primary agriculture to alleviate poverty and sell surplus to obtain income. The predominant agricultural activities among smallholder farmers that are taking place in the Amatole District Municipality are seasonal maize production, poultry, horticulture, cattle (dairy and beef), small stock (sheep and goats), and forestry [21]. Amongst the natural vegetation of the forests and grasslands is the abundant availability of indigenous medicinal plants that are indigenous to the study area, which the dominant Xhosa tribe calls “Amayeza” or “Umthi” [22]. The study was conducted in this district to investigate the participation of smallholder farmers in the production and sustainable use of indigenous medicinal plants to develop a sustainable livelihood. The plentiful availability of medicinal plant resources around them provides easy access to these indigenous medicinal plants without exhausting so many input resources. Figure 1 shows the study sites.

2.2. Data-Collection Methods and Sampling Techniques

The research design for the study was cross-sectional, where data was collected from smallholder indigenous medicinal plant farmers at a single time without a repetition of the sample. The study made use of primary data. Primary data was collected through the use of self-administered structured questionnaires. The structured questionnaires were used to obtain data on socio-economic demographics, challenges affecting smallholder indigenous medicinal plant farmers, profitability, conservation strategies, and contribution to household welfare. The reliability of the questionnaires was assured as to appropriateness through a pre-test before the data collection. The pre-testing of the questionnaire was also important for training enumerators who were responsible for administering the questionnaires. The enumerators were fluent in the local language, which is Xhosa. The study selected the participants voluntarily and without cohesion. The researcher worked in close liaison with the extension officers for assistance in identifying smallholder medicinal plant farmers of the Amatole District Municipality. The data were collected from 15 June to 31 August 2023. Participation in the study was voluntary, and all participants provided informed consent without coercion or undue influence.

A multi-stage stratified sampling technique was used for selecting the study participants. The study adopted three-stage multi-stratified random sampling. Initially, in stage 1, local municipalities and wards with significant availability of indigenous medicinal plants were purposively chosen, focusing on Mnquma and Mbashe Local Municipalities, to align with the study’s objectives. This non-probability sampling method facilitated targeted interviews with individuals who could provide detailed insights relevant to the research. In the second stage, the farmers were stratified based on various criteria, such as socio-economic characteristics, farming practices, and institutional factors, resulting in 3 strata categories, including Strata 1—indigenous medicinal plant farmers, Strata 2—crop farmers, and Strata 3—livestock farmers. Then, the study chose Strata 1, which aligns with the study objectives. Finally, a random selection process was employed within Strata 1 to finalize the desired sample of 150 smallholder indigenous medicinal plant farmers for the study. A sample of 150 smallholder medicinal plant farmers was selected with the hope that they would produce unbiased responses. The use of the Cochran formula to calculate sample size was because there was limited information about the indigenous medicinal plant farmer’s population, and the use of Cochran played an important role in determining the sample size. According to the equation below, the unadjusted sample size is required to be 150.

$$n_1=\frac{Z^{2}p\left(1-p\right)}{e^2}$$

where

n = required sample size;

Z = confidence level at 95% (standard value of 1.96);

p = estimate of smallholder indigenous medicinal plant farmers which is at 0.89. This was an assumption that 89% of smallholder farmers participate in the production of indigenous medicinal plants in the study area;

q = This is the weighting variable given by 1 − p;

e² = Margin of error at 5% (standard value of 0.05).

$$=\frac{{1.96}^2\times 0.11\times 0.89}{{0.05}^2}=150$$

The study’s sample size was 125 participating in indigenous medicinal plant farming and 25 non-participating in indigenous medicinal plant farming. The overall sample size of 150 smallholder indigenous medicinal plant farmers ensures adequate statistical power to detect significant differences and relationships of interest in the study, enhancing the robustness of the findings. This size strikes a balance between precision and feasibility, enabling precise estimates of the parameters, like means and correlations, while managing resource constraints, such as time, personnel, and finances, effectively. It also supports population representation by encompassing the diversity of farmers in the Amatole District Municipality through stratified sampling, thereby enhancing the study’s generalizability. Overall, a sample size of 150 is manageable logistically, facilitating efficient data collection, analysis, and interpretation within the study’s operational scope.

2.3. Data Analysis

The study employed descriptive statistics and propensity-score matching for analysis. The significance of using descriptive statistics in the study is to assess the conservation strategies that can be used to sustain the use of indigenous medicinal plants; the scale allowed the respondents to rate the conservation strategies according to their own experience and how they relate to them. The mean score was produced by the total summation of the product of rating points and observation divided by the total sample size [22].

The socio-economic characteristics of the study were analyzed and defined using descriptive statistics. The study used graphs, sums, tables, averages, and frequencies. This analytical tool was employed to examine the social profile of the smallholder farmers and their farming practices that are aimed at conserving nature’s biodiversity.

Analytical Tool

The study implemented propensity-score matching (PSM) to assess the impact of conservation and the sustainable use of indigenous medicinal plants on the economic well-being of smallholder farmers. The PSM method was good for its capacity to improve the capability of the regression to accumulate precise causal evaluations by its non-parametric method to stabilize covariates between the participants and non-participant groups in the effects of the conservation and sustainable use on the economic well-being of smallholder farmers [23]. PSM was used by [24,25] in their impact studies. To measure impact estimation, numerous econometric techniques were considered, such as reflexive comparison, instrumental variable methods (IV), matching methods (MM), and difference-in-difference (DD) methods.

Propensity-score matching (PSM) is a statistical method used in observational studies to mitigate bias by pairing treated subjects (those receiving treatment) with control subjects (those not receiving the treatment) who share similar characteristics. Unlike randomized controlled trials, observational studies face challenges in assigning subjects randomly to treatment groups, relying instead on existing group distinctions. PSM addresses the bias stemming from confounding variables that affect both treatment assignment and outcomes by equating groups based on a propensity score—a probability estimate derived from the observed subject characteristics. This technique enhances comparability between the treated and control groups, thereby improving the validity of causal inferences drawn from non-randomized data. Propensity-score matching (PSM) aims to balance observed covariates between treatment and control groups by matching subjects with similar propensity scores, thereby enhancing comparability. It is versatile, accommodating various treatments and outcomes across disciplines, like healthcare, economics, and the social sciences. By reducing selection bias from confounding variables, PSM improves the accuracy of treatment effect estimates compared to simple observational comparisons. It often provides better control over bias than traditional regression methods, particularly in studies with numerous covariates or complex interactions. Additionally, the transparency of the propensity score aids in interpreting the results, while its application can increase analytical efficiency in studies with small treatment effects or limited sample sizes.

The study employed the use of matching methods to compare the effects of conservation and sustainable use on the economic well-being of participants and non-participants with relatable socio-economic background features. Matching solely controls for changes in the observable characteristics and biases are expected to occur, emerging from unobserved variables that have the potential to influence participation in the program [26]. The average effect of treatment on the treated ($ATT$) can be illustrated as follows:

$$ATT=E\left(y_{li}-y_{0i}|D_i=1\right)=E\left(y_{li}|Di=1\right)-E\left(y_{01}|D_i=1\right)\dots \dots \dots$$

(1)

where

$y_{li}$ symbolizes the economic welfare of farmers (income generation for $i$th smallholder farmers generated through the conservation and sustainable use of the indigenous medicinal plants group, $y_{0i}$ is the income of the smallholder farmers that are not participating in the conservation and sustainable use of indigenous medicinal plants farming, and $D_i$ is a treatment gauge equal to 1 (conservation and sustainable use of indigenous medicinal plants farming and 0 (otherwise). Meanwhile, it was difficult to estimate how income generation would have been, given that there was no participation in the maintainable conservation and sustainable use of indigenous medicinal plant farming. The key problem we were exposed to was that of estimating the suitable counterfactual: $y_{li}\left|D_i=0\right).$ For reasons emanating from the self-selection of non-random farmers, a comparison between non-participants and participants is likely to generate biased estimates. An appropriate control group with non-participants that have related comparable demographics to individuals who do not participate in the conservation and sustainable use of indigenous medicinal plant farming was constructed through the use of the PSM technique [26,27,28,29]. Empirically, the PSM technique adopts two stages. First, a probability model is created to evaluate each smallholder farmer’s likelihood $p\left(x_i\right)$ to participate in the conservation and sustainable use of indigenous medicinal plants farming, assuming their prevailing characteristics, $x_i$ [26,27].

$$\mathrm{Pr}\left(D_i=1|x_i\right)\equiv p\left(xi\right)$$

(2)

Second, the $ATT$ of practicing conservation and sustainable use of indigenous medicinal plants farming on the economic welfare of smallholder farmers $\left(yi\right)$ is predicted, considering the matched observations of participation and non-participants, as illustrated:

$${ATT}^{psm}=E\left[y_{li}|D_i=1,p\left(x_i\right)\right]-E\left[y_{0i}\right|D_i=0,p\left(x_i\right)]$$

(3)

where

${ATT}^{psm}$ estimates the mean-variance of conservation and sustainable use of indigenous medicinal plants farmer participants matched with non-participants who reside in the same study area with similar socio-dynamics and are well-adjusted on their propensity scores [26,27,28].

3. Findings and Discussion

This section is divided into two. The first profiles the socio-demographic factors. The second section analyses the conservation strategies used by medicinal plant farmers.

3.1. Socio-Economic Characteristics of Smallholder Farmers in the Amatole District

The sustainable conservation strategies for indigenous medicinal plants were estimated by smallholder farmers who utilized conservation strategies for environmental preservation. The sampled 150 medicinal plant farmers exposed that 125 farmers were medicinal plant farming participants, and 25 of the farmers acknowledged having information about the existence of medicinal plants but did not participate in the production of medicinal plants, including the conservation of species diversity and environmental preservation.

Table 1. Socio-economic characteristics of smallholder farmers in Amatole District Municipality medicinal plant participants and non-participants.

Characteristics	Medicinal Plant Participants (n = 125)	Non-Medicinal Plant Participants (n = 25)	Overall (n = 150)
	Mean	Mean	Mean	t-Test
Gender (female)	0.59	0.74	0.67	0.002 **
Access to credit (No)	0.30	0.28	0.29	0.018 **
Marital Status (Married)	0.68	0.66	0.67	0.028 **
Extension Visits (5 times)	0.57	0.58	0.56	0.013 **
	Mean	Mean	Mean	Chi-sq
Age	0.56	0.32	0.44	0.002 ***
Educational level	7.4	12.8	10.6	0.023 **
Household size	6.00	5.00	5.62	0.016 **
Farm size (Ha)	0.92	0.98	0.95	0.034 **
Farming experiences (year)	16.44	4.36	10.42	0.127

Note: *** and ** represent 1% and 5% significant levels, respectively.

illustrates the demographic characteristics of smallholder farmers in the study.

As reflected in Table 1 above, the results of the study portrayed that indigenous medicinal plant farmers of the Amatole District Municipality (ADM) are mostly females. Female farmers of indigenous medicinal plants are approximately 67%, and this implies that women assume a leading role in the primary production of indigenous medicinal plants rather than their male counterparts. These results relate to the findings presumed by [30,31], who found that females engage in more roles in medicinal plant farming, in particular the backyard gardening of medicinal plants. The age of the smallholder farmers who are in indigenous medicinal plant production averages 44 years of age. These findings suggest that most of the smallholder indigenous medicinal plant farmers are middle-aged women. The findings of the study were in line with [32], who found that middle-aged women participate more in practices of medicinal plants because they are more knowledgeable than the younger generation and have more strength than the older generation, and that is what drives their urge to the production of medicinal plants.

The results depict that the average educational level of the medicinal plant farmers of the ADM is 10 years in school. Ten years in school indicates a decent level of literacy, understanding, and intellect, which makes one capable in the capacity to make informed decisions. Ref. [33] presented similar findings, showing that farmers with formal education are likely to make more rational decisions and are capable of contributing valuable inputs to their farming operations. The results show that the extension visits in the Amatole District Municipality per year were five times per month. Extension and advisory services (EAS) constitute an integral part of the knowledge and skills of smallholder indigenous medicinal plant farmers through the dissemination of lucrative agricultural information. The study results are consistent with those of [34], who found that extension systems are effective when they give valuable, consistent, and relevant information to local smallholder farmers to make a pivotal impact in the use of significant medicinal plant resources and sustainable farming. Smallholder indigenous medicinal plant farmers had no access to credit, and they relied on social securities from the government, including social grants, farm returns, and remittances, to purchase inputs and farm operations. The IMP farmers were married and, thus, assisted in farming through decision-making. Married farmers always prioritized decisions that would favor the farm in enhancing farm returns so that they can be able to sustain the family. This variable provided the potential for increased labor availability and the division of responsibilities. In many traditional agricultural settings, married couples often work together on the farm. This collaboration allows them to effectively manage various tasks, such as cultivating, harvesting, and processing indigenous medicinal plants.

The findings of the study illustrated that, on average, households had five members and occupied land sizes that were less than 1 ha. The results suggest that there is an availability of labor force, since smallholder indigenous medicinal plant farmers often source their workforce from family members, thus giving them an advantage in cost minimization. These study results are consistent with the study conducted by [35], who distinguished that members of the family participate as an extra force in farm work and non-farm activities to generate more income while saving significantly on labor costs. The results of the study reveal that medicinal plant farmers have 11 years of experience in farming. These findings influence the farmer’s ability to make decisions because experience has created hindsight of past events and an understanding of how solutions were made. The study results correspond with [36], who exposed that smallholder farmers with longer experience in the production of indigenous medicinal plants are considered to have better strategies to counter rising challenges and risks.

3.2. The Benefits of Having Indigenous Medicinal Plants in Our Communities

The information about the benefits of having indigenous medicinal plants in our communities was gathered from a field survey of a sample of 150 respondents that were chosen by the study.

Table 2. The benefits of having indigenous medicinal plants in our communities.

Benefits of Having Medicinal Plants	Mean
Household consumption	0.76
Livestock health	0.69
Cultural rituals	0.57
Local sales	0.53
Traditional healing	0.42

below depicts the benefits of having indigenous plants in our communities as in the case of the Amatole District municipality.

Table 2 above indicates that household consumption in the event of illness was the greatest benefit that the smallholder medicinal plant farmers exploited from the use of medicinal plants. Approximately 76% of rural smallholder farmers use medicinal plants to maintain the health of family members in their households. This could be attributed to the fact that medicinal plants are cheaper to resort to as medicine than to purchase manufactured medicine. Additionally, rural areas are mostly situated distantly from towns. Therefore, herbal medicine is the fastest option reachable in the event of the sickness of a family member. The study results were consistent with those of [37], who found that herbal medicine is cheaper than manufactured medicine. Hence, the majority of rural people consider them.

To keep livestock in a healthy state ranks second for the benefits of having indigenous medicinal plants in our communities. About 69% of the rural smallholder farmers reap a large benefit from medicinal plants, as they can use them to maintain the health of their herds. This could be a result of livestock being one of the primary commodities that rural smallholder farmers pride themselves on having as a tool to alleviate poverty. Therefore, the availability of affordable medicine protects assets, such as livestock and cash for medicine. Smallholder farmers draw a livelihood from nutrition and saving money for alternative uses. The study was in line with that of Jayakumar et al. [38], who found that herbal medicine plays a significant role in the health of livestock in rural areas, and its affordability saves smallholder farmers money to invest elsewhere.

The use of medicinal plants for cultural rituals and beliefs was one of the benefits of having access to medicinal plants in close proximity to where people live; about 57% of smallholder farmers attest to this benefit. The reason for embracing the benefits of medicinal plants for rituals and beliefs could be that certain medicinal plants are sometimes demanded by culture and, therefore, one could feel the need to acquire the plant from faraway places just to fulfill his or her cultural desires. Additionally, when there is a shortage of these plants on the market, the price of getting them rises. The rise in these prices solicits funds that were initially going to be for household food and nutrition. However, smallholder farmers appeared to be very adamant about fulfilling cultural desires. The study results are consistent with those of Shah et al. [39], who found that faith in religion plays a pivotal role in influencing a smallholder farmer to adopt the use of medicinal plants, and it drives them to lengths and depths to ensure that they get the plants they need just to fulfill beliefs.

The sales of “Muthi” to local markets are one of the benefits of local access to indigenous medicinal plants. About 53% of the smallholder farmers of the Amatole District Municipality of the Eastern Cape confirmed that they were involved in the trading of medicinal plants. This could be attributed to reasons such as medicinal plants having a booming market, being sellable from the street corners, and not needing a large amount of capital to start. Therefore, smallholder farmers use medicinal plants as an avenue to draw financial benefits in order to feed their households sustainably. The results are in line with those of Ambu et al. [40], who found that the trade of medicinal plants is an additional livelihood option for the poor and smallholder farmers, and it contributes greatly to their food and nutritional security.

Using medicinal plants as a traditional healer when consulted by patients was found to be one of the benefits of having medicinal plants in our communities. About 42% of the traditional healers that were interviewed confirmed that there are additional financial benefits exploited from the consultations of people. This could be attributed to the claims that traditional healers can navigate one’s life spiritually and diagnose a person’s illness before fiddling with trial and error. Therefore, these claims draw more people to consult these diagnoses that are drawn from sacred medicinal plant sources that they were not comfortable sharing. The study is in line with those of Ambu et al. [40], who found that the incentives made by traditional doctors to heal people are highly profitable and are capable of sustaining people’s households for as long as the traditional healer lives.

4. Constraints Faced by Smallholder Farmers in the Use of Indigenous Medicinal Plants

The availability of indigenous medicinal plants at the convenience of rural smallholder farmers has proven to be beneficial in multiple ways. However, the smallholder farmers appear not to be doing a good job of conserving these indigenous medicinal plants so that they can sustain them for future generations to come. This section was considered to understand the constraints preventing the adoption of conservation and a sustainable framework by smallholder farmers of indigenous medicinal plants. Figure 2. below illustrates the constraints faced by smallholder farmers in conserving and sustaining indigenous medicinal plants, as per the study. The results regarding the constraints faced by smallholder farmers in the conservation and sustainable use of indigenous medicinal plants highlight critical challenges that directly influence the study’s objectives of harmonizing traditional knowledge with environmental preservation and enhancing economic well-being.

According to the study results, lack of knowledge in seed propagation (30%) is a primary constraint that limits smallholder farmers in the conservation and sustainable use of indigenous medicinal plants. Seed propagation can be a complex subject for people who have limited education or the skill to propagate seeds. This constraint underscores a significant gap in traditional knowledge transmission and agricultural practices among smallholder farmers. Effective seed propagation is essential for maintaining the genetic diversity and sustainability of indigenous medicinal plants. Addressing this gap is crucial for ensuring the continuity of plant populations and the resilience of ecosystems. Moreover, indigenous medicinal plants must be wild species that are not often around people’s households. So, consistently making plans to conserve them is very crucial, but the lack of knowledge makes it very hard for smallholder farmers. The lack of knowledge (awareness) of the implications of endangerment (28%) is the second challenge faced by smallholder farmers. Awareness about the endangerment status of indigenous medicinal plants is pivotal for informed conservation efforts. Without understanding the implications of endangerment, smallholder farmers may inadvertently contribute to the decline of plant species through unsustainable harvesting or land-use practices. Educating farmers about conservation status and strategies is essential for fostering a responsible stewardship of plant resources.

The removal of forests with the motive of building houses (26%) is an increasing challenge, and this disturbs the biodiversity in rural areas. The encroachment and habitat loss due to urbanization and land conversion pose significant threats to biodiversity and ecosystem health. The removal of forests for housing construction not only diminishes habitat for indigenous medicinal plants but also disrupts ecosystem services that are crucial for human well-being. Balancing urban development with conservation priorities is essential for mitigating these impacts. The last challenge faced was the lack of financial support for smallholder farmers (16%), and this is the most common challenge for most smallholder farmers in South Africa that disrupts farm operations and investment in up-to-date inputs. Financial constraints limit the ability of smallholder farmers to invest in sustainable farming practices, infrastructure development, and conservation initiatives [27,41]. Adequate financial support is necessary to empower farmers economically, enabling them to adopt sustainable practices, access markets, and withstand economic shocks.

5. Examination of Used Conservation Strategies on Rural Indigenous Medicinal Plants

The examination of conservation strategies by smallholder farmers in the production of medicinal plants was measured to investigate the knowledge of smallholder farmers of the strategies to conserve natural resources. A sample of 150 farmers was investigated.

Table 3. Examination of conservation strategies used on indigenous medicinal plants by smallholder medicinal plant farmers.

Conservation Strategies		Frequency	Mean
			$\left(\genfrac{}{}{0pt}{}{\mathit{n}}{150}\right)$
In Situ Conservation	Protect areas	62	0.41
	On-farm conservation	39	0.26
Ex Situ Conservation	Botanical Gardens	0	0
	Gene Banks	0	0
Production process	Good Agricultural Practises (GAP)	6	0.04

illustrates the percentage scores of their responses.

According to Table 3, the most practiced conservation strategies are in situ conservation. Under in situ conservation, we have protected areas, which are protected areas, and on-farm conservation. According to the field survey, 41% of the smallholder farmers practiced the protected-area conservation strategy, 26% practiced the on-farm conservation strategy, and the remaining 23% did not practice any form of conservation measure. This implies that the protected-area conservation strategy was the most conducive for smallholder medicinal plant farmers. Protected areas in the case of the Amatole District Municipality are achieved through the use of landmarks, dongas, rivers, and boundaries to demarcate certain camps and restrict entry for conservation purposes. This is how rural people protected their forests from external intruders who wanted to benefit from medicinal plants that were not from their territories. This study’s results are in line with those of Makamane et al. [41], who found that barriers, checkpoints, and landmarks are effective tools of segregation. Moreover, they are very effective in rural settings to protect a certain village from the harvesters of another village.

Approximately 26% confirmed that they conserve medicinal plants on their farming land through micro-nurseries and transplanting to their farmland. Domestication is an attribute of indigenous knowledge that their forefathers were using to bring medicinal plants closer to service when needed. These study results were in line with those of Umar et al. [42], who found that the domestication of medicinal plants impacts positively the ecological security of biodiversity.

6. Impact of Conservation and Sustainable Use of Indigenous Medicinal Plants on Economic Well-Being of Smallholder Farmers

The study made use of propensity-score matching to estimate the impact of conservation and the sustainable use of indigenous medicinal plants on the economic well-being of smallholder farmers in the Amatole District Municipality. The results are shown in

Table 4. Effects of conservation and sustainable use of indigenous medicinal plants on the economic well-being of farmers.

Output Variable	Kernel Matching Method
	ATT	Standard Error	p-Value
Economic well-being (income generation)	6824.641	5912.56	0.001 **
	Nearest Neighbor Matching Methods
	ATT	Standard error	p-value
Economic well-being (income generation)	7672.691	6472.691	0.003 ***

Notes: *** and ** mean significant at 1% and 5% levels, respectively. Model summary: number of observations = 150, matches requested = 7, treatment model = Logit.

below. The analysis was based on a sample of 150 smallholder farmers using a Logit treatment model. Matching methods were employed to control for potential confounders and ensure the reliability of the results. The high number of observations and the request for matches (7) further strengthen the robustness of the statistical analysis.

Table 3 illustrates that conservation and sustainable use were very effective and have enhanced the economic well-being of farmers. According to the kernel matching method, the average treatment effect on the treated (ATT) for economic well-being (income generation) is estimated to be approximately ZAR 6824.641. This suggests that smallholder farmers who engage in conservation and sustainable-use practices toward indigenous medicinal plants experience an average increase in economic well-being by this amount compared to non-participants. The standard error associated with this estimate is 5912.56, indicating a measure of uncertainty, but the p-value of 0.001 ** signifies high statistical significance at the 1% level. This robust result underscores the positive impact of such practices on income generation among farmers. Similarly, by using the nearest neighbor matching method, the ATT for economic well-being is estimated at approximately ZAR 7672.691, with a standard error of 6472.691 and a p-value of 0.003 ***. This confirms the significant economic benefits derived from conservation efforts, reinforcing the findings observed with the kernel matching method. These results underscore that there are tangible economic benefits from the conservation and sustainable use of indigenous medicinal plants by smallholder farmers. The findings highlight the importance of integrating and blending traditional knowledge with modern conservation approaches for the sustainable development of rural areas yields positive economic benefits.

7. Implications for Food Security and Nutrition

According to Table 2, medicinal plants played a crucial role in the lives of smallholder medicinal plant farmers. They contributed imperatively to food security and nutrition, particularly through the household consumption of medicinal plants, livestock health, local sales, and cash exchanges received from traditional healing services. The household consumption of medicinal plants included the advantage that smallholder medicinal plant farmers embrace having access to medicinal plants in close proximities, saving them all the costs of acquiring them from a distance. The value of the money that is saved can be used by the farmers to ensure food availability for their households. These findings are in line with Gülzau et al. [43], who found that the production of medicinal plants boosts food security by saving significantly on the costs imposed when having to purchase from other producers. Livestock health has a dual benefit for medicinal plant producers. Livestock were the pride of these smallholder medicinal plant producers, as they were their form of banking and food. The maintenance of livestock health increased market value, which enabled them to fetch a higher income upon sale and, therefore, have plenty to bring back home. The study results were consistent with Ramawat et al. [44], who found that livestock contributes significantly to food availability and access through incorporation into daily diets, and its sales can provide income to households of smallholder medicinal plant farmers to enhance their livelihood.

However, Table 3 displayed the alarming results that smallholder medicinal plant farmers did not have sustainable conservation strategies in place, as there were only 41% of farmers growing medicinal plants in protected areas, 26% on farms, and 0.04% who were compliant with good agricultural practices (GAP). These results could be attributed to a lack of knowledge of seed propagation, a lack of awareness of implications, and the removal of forests to build houses, as per the results in Figure 2. The aforementioned is highly detrimental to the food security and nutrition of smallholder medicinal farmers, as they have adverse effects on income flow and destabilize future access to medicinal plants. Conservation ensures the access and availability of medicinal plants for generations. If not maintained, it may lead to the extinction of lucrative medicinal plant species that smallholder farmers maintain their livelihoods. Therefore, without proper mitigation measures, many households would be exposed to starvation. This was echoed by [37]; Chowdhury et al. [45]; Mapiye et al [46]; Obayelu [47], who found that conservation is the cornerstone of safeguarding species diversity to maintain sustainable income streams for smallholder medicinal plant farmers.

8. Conclusions

The incorporation of indigenous knowledge in the conservation of indigenous medicinal plants is an integral part of biodiversity protection in rural areas. This can be achieved through the employment of various conservation strategies. These strategies are difficult to apply in rural settings scientifically, but community elders have ancient methods that they apply to safeguard their species from extinction. These conservation strategies are very important because they ensure that the livelihood of medicinal plant farmers is improved, and food and nutritional security are maintained through the maintenance of the plants that they sell to receive cash incentives. However, the study found that rural farmers are not very good conservers of natural resources. There are some strategies that they use to conserve, such as protected areas and on-farm conservation, but it is a fairly small amount of smallholder farmers who have adopted them. Therefore, the study recommends the interventions of government and extension advisory to raise awareness campaigns and offer technical advice on conservation strategies. The lack of information calls for intensification in the rural development of smallholder farmers through information transfers. However, if these were to be managed thoroughly, they could ensure food and nutrition security for a lifetime.