Resilience of Indigenous healthcare systems: Ethnobotanical approaches among the Baka, southeastern Cameroon

Abstract Indigenous Peoples rely on biodiversity and traditional knowledge for health and well‐being, yet biological and cultural systems are threatened by ecological and social changes. Limited understanding exists on the factors that support the resilience of Indigenous Peoples' healthcare systems—the capacity of a healthcare system to adapt to disturbances while continuing to provide appropriate health services. This study explores how medicinal plants and ethnobotanical knowledge contribute to the resilience of Indigenous Peoples' healthcare systems, working specifically with the Baka, forager‐horticulturalists from Cameroon. The Baka rely on medicinal plants for their health but face several social and ecological challenges that affect their livelihood, culture and well‐being. We explored how the Baka healthcare system prevents and treats different health issues with plant‐based remedies, assessed the contribution of plant species in this system and evaluated potential threats to the Baka healthcare system. Using a mixed‐methods approach combining free listing of medicinal plants, self‐reported health recalls, walk‐in‐the‐wood trips, individual knowledge surveys and botanical collection, we engaged 263 individuals (108 children and 155 adults) across two settlements. We developed indices to evaluate the resilience of the healthcare system. We identified 281 medicinal plant species used to treat 104 health issues, resulting in a total of 1187 remedies (i.e. pairings of a single species with a specific health issue). Twelve species were used for many health problems (considered as having moderate‐to‐high multifunctionality), and 135 species were used in uncommon ways (considered atypical). Nine health issues were treated by a few plant species (considered low‐redundancy issues). About 40 species were found to be under pressure from logging, market demands or under conservation threats, with implications for the whole healthcare system. By integrating different ethnobotanical methods, this research provides a detailed understanding of medicinal plant diversity and therapeutic redundancy within the Baka healthcare system. We discuss the potential of ethnobotanical indices to help assess the resilience of healthcare systems—and, broadly, social‐ecological systems. We also discuss the implications of our insights for public health policies targeting the Baka and other Indigenous Peoples, as well as for the conservation of biocultural diversity. Read the free Plain Language Summary for this article on the Journal blog.