Prioritising Medicinal Plants for Sustainable Management in a High-Andean Community of Peru: A Cultural–Environmental Index

Plant-based traditional medicine underpins primary health care across rural areas, yet its long-term continuity depends on both the transmission of local knowledge and the management of the plant resources that sustain this practice. This study aimed to identify medicinal plant species in Colcamar district (Amazonas, Peru) that combine high cultural importance with deficient reported environmental management, using a sustainability-oriented cultural–environmental prioritisation index. An observational, analytical cross-sectional study was conducted in five annexes of Colcamar district. Household heads and traditional medicine practitioners (n = 87) were interviewed during a single ethnobotanical field campaign in 2025, generating 1038 plant-informant records for 102 species with taxonomic identification and at least one valid plant-informant record. Cultural importance was estimated using the relative frequency of citation (RFC). Environmental management was assessed using a custom instrument of 11 indicators evaluated through exploratory factor analysis, Cronbach’s alpha, and intraclass correlation by informant. The factor analysis yielded a two-factor solution (KMO = 0.786; 50.6% of variance explained): socio-economic valuation and environmental management. Internal consistency was acceptable for the total scale (alpha = 0.826) and for each retained factor (alpha ≥ 0.85). Three indicators with intraclass correlation below 0.10 (source of acquisition, cultivation technique, and agroecosystem practices) varied across species and were used to build the environmental management index (EMI). Hierba santa (Cestrum auriculatum Lindl.) showed the highest cultural importance (RFC = 0.540), whereas pava (Petiveria alliacea L.) showed the lowest environmental management (EMI = 0.250), defining priority groups for management intervention. Exploratory regression suggested an unconfirmed trend towards higher socio-economic valuation among expert informants, although this finding should be interpreted cautiously because the global model was not statistically significant and only seven informants were classified as experts. The index should be interpreted as a sustainability-oriented prioritisation tool rather than as a direct ecological estimate of population status, regeneration, or harvesting pressure.